Individual
MARY LEE FERTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
303 HIDDEN COVE CIR, GALLUP, NM 87301-5730
(505) 862-3697
Mailing address
303 HIDDEN COVE CIR, GALLUP, NM 87301-5730
(505) 862-3697
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R43323
NM
Other
Enumeration date
01/05/2009
Last updated
01/05/2009
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