Individual
STEPHENIE NICOLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
GALLUP INDIAN MEDICAL CENTER, 516 E. NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
900 BOARDMAN DR APT J96, GALLUP, NM 87301-4746
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
4704267980
MI
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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