Individual
MIRTHA ZAMUDIO DERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
8080 E SPEEDWAY BLVD UNIT 804, TUCSON, AZ 85710-1662
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN203256
AZ
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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