Individual
ELIZABETH KOSTER GISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1310
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1310
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
212250
SC
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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