Individual
LEANNA M GAISTHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COMMUNITY HEALTH WOR
Contact information
Practice address
1423 E ROOSEVELT AVE, GRANTS, NM 87020
(505) 287-6500
(505) 287-5393
Mailing address
1208 BONITA AVE, GRANTS, NM 87020
(505) 287-6500
(505) 287-5393
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
S1-15023
NM
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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