Individual
JOLENE PLATERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
413 SAGUARO DR, GALLUP, NM 87301-6778
(505) 402-6129
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
R53413
NM
Other
Enumeration date
01/13/2017
Last updated
01/13/2017
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