Individual
JERELYN GENESE OLIVAR I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1807
(505) 721-1899
Mailing address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1807
(505) 721-1899
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R40938
NM
Other
Enumeration date
03/05/2019
Last updated
03/05/2019
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