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Individual

DENNIS JOHN JUNG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
2025 GALISTEO ST, SANTA FE, NM 87505-2101
(505) 995-4901
(505) 989-6426
Mailing address
2025 GALISTEO ST, SANTA FE, NM 87505-2101
(505) 995-4901
(505) 989-6426

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN27843
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10009148
LOVELACE
01
201004971
PRESBYTERIAN HEALTH PLANS
01
2340212
UHC
05
98478
NM
01
NM006954
BCBS NM
NM
01
QMYPR0069326
MOLINA
Enumeration date
03/09/2006
Last updated
11/08/2011
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