Individual
DOROTHY WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
516 EAST NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1421
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1421
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R067660
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401790100
—
MD
Enumeration date
07/26/2005
Last updated
03/18/2014
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