Individual
KELLY GEMMILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3160 AGUA FRIA ST, SANTA FE, NM 87507-5402
(505) 467-4605
Mailing address
3076 PLAZA BLANCA, SANTA FE, NM 87507-5342
(757) 719-4550
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
0001302317
VA
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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