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Individual

SHERRY ANN POLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1217 BONITA ST, GRANTS, NM 87020-2103
(505) 287-2958
(505) 287-2403
Mailing address
504 LEACH AVE, GRANTS, NM 87020-2041
(505) 290-5780

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R54563
NM
363LF0000X
Family Nurse Practitioner
Primary
70171
NM

Other

Enumeration date
09/26/2022
Last updated
11/11/2022
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