Individual
MRS. VERNITA RAE GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 624-8739
(505) 624-8757
Mailing address
PO BOX 265, ROSWELL, NM 88202-0265
(505) 623-1406
(505) 624-8757
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
066
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00056342
—
NM
Enumeration date
12/08/2006
Last updated
07/09/2007
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