Individual
SHERRY BETH DESTROMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-4985
Mailing address
43 COUNTY ROAD 116, ESPANOLA, NM 87532-9749
(505) 480-5413
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L17965
NM
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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