Individual
GWENDOLYN LIVINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
3626 CINIZA DR, GALLUP, NM 87301-4521
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
82204
NM
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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