Individual
EVAN JACKSON FROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT-B
Contact information
Practice address
2052 GALISTEO ST, SANTA FE, NM 87505-2100
(505) 819-3419
Mailing address
904 BISHOPS LODGE RD, SANTA FE, NM 87501-1131
(505) 819-7317
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
1016380
MN
Other
Enumeration date
02/09/2023
Last updated
02/09/2023
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