Individual
JOHN PATRICK CANNISTRARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED NURSE
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1790
Mailing address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1790
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN184591
AZ
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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