Individual
GLORIA FAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
909 PERRY MEADOWS DR NE, RIO RANCHO, NM 87144-7596
(505) 350-0229
Mailing address
909 PERRY MEADOWS DR NE, RIO RANCHO, NM 87144-7596
(505) 350-0229
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
R30491
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R30491
RN
NM
Enumeration date
08/11/2009
Last updated
08/11/2009
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