Individual
MR. JOSEPH LEE ELIASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP, FNP-C, CWS
Contact information
Practice address
520 NM - 564, GALLUP, NM 87301-5881
(505) 522-3681
(505) 473-9552
Mailing address
2418 E HISTORIC HIGHWAY 66 # 292, GALLUP, NM 87301-4767
(505) 906-6581
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
R040994
SD
363LF0000X
Family Nurse Practitioner
Primary
APRN-CNP69689
NM
Other
Enumeration date
11/17/2021
Last updated
02/27/2026
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