Individual
DARLENE ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 N DATE ST, T OR C, NM 87901-2377
(575) 894-7589
Mailing address
405 N DATE ST, T OR C, NM 87901-2377
(575) 894-7589
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R66423
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R66423
BOARD OF NURSING LICENSE
NM
Enumeration date
02/23/2016
Last updated
02/23/2016
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