Individual
MS. BERNADETTE DAYZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
KEWA PUEBLO HEALTH CORPORATION, 85 W HWY 22, SANTO DOMINGO PUEBLO, NM 87052
(505) 465-3060
Mailing address
PO BOX 340, SANTO DOMINGO PUEBLO, NM 87052-0340
(505) 465-3060
(505) 465-1185
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
105014
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Z7054
—
NM
Enumeration date
12/19/2006
Last updated
12/02/2021
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