Individual
MRS. SHAVON ELIZABETH CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1800
Mailing address
1000 E AZTEC AVE, GALLUP, NM 87301-5509
(505) 721-1800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN89723
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730210113
—
NM
Enumeration date
03/06/2019
Last updated
03/06/2019
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