Individual
LORETTA KENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1421
Mailing address
P.O. BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1421
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209004287
IL
Other
Enumeration date
12/14/2005
Last updated
01/27/2010
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