Individual
GWENDOLYN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 1199, SHIPROCK, NM 87420-1199
(505) 368-4984
(505) 368-5502
Mailing address
PO BOX 1199, SHIPROCK, NM 87420-1199
(505) 368-4984
(505) 368-5502
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
53213
NM
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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