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Individual

ALISON GAGNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
31039B HWY 64, CIMARRON, NM 87714-9646
(575) 376-2402
Mailing address
204 TURF DR, RATON, NM 87740-2005
(303) 596-6101

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-03092
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
573270YM1K
NM
Enumeration date
09/07/2016
Last updated
10/26/2023
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