Individual
MS. GINA M FULLBRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2520 S TELSHOR BLVD, LAS CRUCES, NM 88011-4907
(575) 522-9793
(575) 532-9019
Mailing address
PO BOX 6310, LAS CRUCES, NM 88006-6310
(575) 522-9793
(575) 532-9019
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
CNP00547
NM
363LW0102X
Women's Health Nurse Practitioner
R28306
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16574052
—
NM
Enumeration date
02/09/2007
Last updated
04/12/2016
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