Individual
JACLYN VASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1451 DONALDSON AVE, ANTHONY, NM 88021-8802
(575) 882-6101
Mailing address
PO DRAWER 70, ANTHONY, NM 88021
(575) 882-6101
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-69224
NM
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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