Individual
BETH MARIE WENGERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
920 E SANTA FE AVE, GRANTS, NM 87020-2436
(505) 287-7472
Mailing address
920 E SANTA FE AVE, GRANTS, NM 87020-2436
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R57462
NM
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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