Individual
MARIAH KAY LASLEY-MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4856
Mailing address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4856
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-84602
NM
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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