Individual
JENNA LINDSAY GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
301 N 2ND ST, LOGAN, NM 88426-8842
(575) 487-2252
(575) 487-9479
Mailing address
PO BOX 272, LOGAN, NM 88426-0272
(575) 403-6512
(575) 487-9479
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-81143
NM
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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