NPI Profile for MARINA FEDOTOWSKY in DEMING, NM.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1942748017 |
|
| Status | Active | |
| Credentials | CFNP | |
| Entity | Individual | |
| Enumeration date | 02/08/2017 | |
| Last updated | 10/26/2022 - About 4 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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MARINA FEDOTOWSKY
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