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Autumn Marie Gonzales
Medical Physician Assistant in Los Alamos, New Mexico
NPI 1073275756

Autumn Marie Gonzales is a Medical Physician Assistant based in Los Alamos, NM and is specialized in Medical. Autumn Marie Gonzales practices in Los Alamos, NM. The NPI Number for Autumn Marie Gonzales is 1073275756 and holds a License No. (New Mexico).

The current practice location address for Autumn Marie Gonzales is 3917 West Rd Ste A, Los Alamos, NM and can be reached out via phone at 505-661-8900.

Location: 3917 West Rd Ste A, Los Alamos, NM, 87544-2292
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073275756
Provider Name
Autumn Marie Gonzales
Credential
Provider Entity Type
Individual
Gender
Female
Address
3917 West Rd Ste A, Los Alamos, NM, 87544-2292
Phone Number
505-661-8900
Fax Number
Provider Enumeration Date
10/09/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3917 West Rd Ste A
City
Los Alamos
State
New Mexico
Zip
87544-2292
Phone Number
505-661-8900
Fax Number
person
Provider Business Mailing Address Details
Address
3917 West Rd Ste A
City
Los Alamos
State
New Mexico
Zip
87544-2292
Phone Number
505-661-8900
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
PA2023-0240 (New Mexico)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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