Individual
MARY JAIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1001 S DIAMOND AVE, DEMING, NM 88030-4710
(575) 546-8841
Mailing address
1321 E POPLAR ST, DEMING, NM 88030-4807
(575) 546-5951
(575) 546-5994
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R32004
NM
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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