Individual
JENNIFER SIESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 721-1000
Mailing address
904 S STRONG DR, GALLUP, NM 87301-5965
(505) 722-1301
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
Primary
526834
TX
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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