Individual
CYNTHIA FRASER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., BSN, MPH
Contact information
Practice address
516 NIZHONI BOULEVARD, BLDG. F, GIMC, PHN, GALLUP, NM 87301
(505) 722-1752
Mailing address
3317 BOX CANYON AVE, GALLUP, NM 87301-6941
(505) 722-1752
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
140786
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68331053
—
CO
Enumeration date
03/28/2007
Last updated
01/04/2012
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