Individual
JERICO GAMIAO ALICANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-2000
Mailing address
7345 WOODLAND DR STE C, INDIANAPOLIS, IN 46278-1737
(317) 286-2885
(317) 536-3097
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
206340
TN
163W00000X
Registered Nurse
874538
TX
163W00000X
Registered Nurse
Primary
R46690
ND
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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