Individual
TINA MARIE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
8150 W 102ND AVE, SAINT JOHN, IN 46373-0450
(708) 267-0217
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
28238881A
IN
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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