Maryanne Miceli

NPI 1184454530 · on the registry since 2024 · sole proprietor

Practice

Address: 13139 Central Ave Ne
Albuquerque, NM 87123
Phone: (505) 459-5054
Organisation at this address: Epic Pathway Llc
Grand Summit Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 117

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Also registered as: 175T00000X
172V00000X
Licence states on file: NM
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2026-06-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Mexico