Individual
MRS. KATHLEEN NAVAR MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN WCC
Contact information
Practice address
1 ABALONE LOOP, MESCALERO, NM 88340
(575) 464-4441
Mailing address
PO BOX 1133, LA LUZ, NM 88337-1133
(575) 921-3305
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R62638
NM
163WW0000X
Wound Care Registered Nurse
Primary
R62638
NM
Other
Enumeration date
10/07/2010
Last updated
10/07/2010
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