Individual
STEVI DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1321 E POPLAR ST, DEMING, NM 88030-4807
(575) 546-5951
Mailing address
PO BOX 1000, BAYARD, NM 88023-1000
(575) 537-4088
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
R66981
NM
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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