Individual
DANA G WILMOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 999-6610
Mailing address
1532 REYNOSA LOOP SE, RIO RANCHO, NM 87124-8751
(505) 999-6610
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R45523
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R45523
NEW MEXICO BOARD OF NURSING
NM
Enumeration date
04/30/2010
Last updated
04/30/2010
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