Individual
KERRIANN MARIA MALOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN,RN
Contact information
Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4337
(505) 632-4371
Mailing address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4337
(505) 632-4371
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
59774
NM
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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