Individual
JOELYNN LOTTY-EVELYN BENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NM0137380712E
NM
Other
Enumeration date
09/28/2012
Last updated
10/29/2012
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