Organization
ST JOHNS COLLEGE HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K IRUNGU (CREDENTIALING MANAGER)
(877) 614-5227
Entity
Organization
Contact information
Practice address
1160 CAMINO CRUZ BLANCA, SANTA FE, NM 87505-4599
(505) 984-6418
Mailing address
1160 CAMINO CRUZ BLANCA, SANTA FE, NM 87505-4599
(505) 984-6418
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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