Individual
ANYSHA GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
656 W MAPLE ST, FARMINGTON, NM 87401-5968
(505) 609-2290
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
77089
NM
Other
Enumeration date
12/14/2023
Last updated
07/24/2025
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