Individual
JERI MANUELITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
CORNER OF ROUTES N12 & N7, FT. DEFIANCE, AZ 86504-8650
(928) 729-8000
Mailing address
6225 BENT TREE DR NW, ALBUQUERQUE, NM 87120-3742
(505) 382-7634
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R65832
NM
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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