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Individual

SUSAN A PUDWILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
6 ROAD 7586, BLOOMFIELD, NM 87413-4934
(505) 632-1801
(505) 368-6476
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 632-1801
(505) 368-6476

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R54540
NM

Other

Enumeration date
01/23/2009
Last updated
01/23/2009
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