Individual
AUDREY DENIECE DUMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3645 NM-47, PERALTA, NM 87042
(505) 869-2679
Mailing address
3645 NM-47, PERALTA, NM 87042
(505) 869-2679
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
82060
NM
163WS0200X
School Registered Nurse
RN-82060
NM
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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