Individual
RICHARD MIERVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
REGISTERED RN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1790
Mailing address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1790
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R82324
AR
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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