Individual
AMY JOALYCE DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-2554
Mailing address
1320 HEART RD, GLENCOE, AR 72539-9504
(870) 273-2595
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
R90507
AR
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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