Individual
MARY ELIZABETH BANGE
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
31 TABOR LN, HAMILTON, OH 45013-5119
(513) 258-5356
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
427315
OH
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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