Individual
DENISE MARIE FALLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
HWY 571 #28, EL RITO, NM 87530
(505) 581-4728
Mailing address
PO BOX 129, EL RITO, NM 87530-0129
(505) 581-4728
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R40330
NM
Other
Enumeration date
04/14/2006
Last updated
02/03/2010
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