Individual
DEITRA GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
610 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2372
(505) 242-3991
(505) 243-8405
Mailing address
610 BROADWAY BLVD NE, ALBUQUERQUE, NM 87102-2372
(505) 242-3991
(505) 243-8405
Taxonomy
Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
CNS-00245
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97304077
—
NM
Enumeration date
01/24/2014
Last updated
07/21/2014
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