Individual
AVALON SANTANA ZAKAZAKINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
454 LIPAN AVENUE, MESCALERO, NM 88340
(575) 464-4802
Mailing address
82 PIONEER DR, TIMBERON, NM 88350-9678
(575) 987-2209
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
76328
NM
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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