Individual
MARLA D. JIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
80 B VETERANS BLVD, SAN FIDEL, NM 87049
(505) 287-7200
(505) 552-5490
Mailing address
80 B VETERANS BLVD, SAN FIDEL, NM 87049
(505) 287-7200
(505) 552-5490
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-69198
NM
163WC1500X
Community Health Registered Nurse
Primary
RN-69198
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1194738328
NPI
—
05
—
30852081
—
NM
Enumeration date
03/04/2009
Last updated
04/24/2026
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