All Medicaid billing entities listing PROVENCIO, DESIREE (MEMBER/MANAGER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| New Mexico | 1 | $357K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | SANDIA VISTA PSYCHIATRIC-MENTAL HEALTH | ALBUQUERQUE, NM | Psychiatric/Mental Health Nurse Practitioner | $357K |