Facts
- Status
- A
- Credential
- RN
- Type
- Individual
- Enumeration date
- 2019-01-10
- Last updated
- 2019-01-10
Licenses
- License NM
- R48067
- License NM
- R48067
Location
- Practice location
- 199 HIGHWAY 50
- City
- PECOS NM
- Postal code
- 875528755
- Phone
- 505-757-6482
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.