Individual
ROSE MARIE SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
GALLUP INDIAN MEDICAL CENTER, 516 EAST NIZHONI BLVD, GALLUP, NM 87305
(717) 222-8617
Mailing address
370 NTH 9TH STREET, LEBANON, PA 17046
(717) 222-8617
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
660697
PA
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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