Individual
FERN S. DETSOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1480
(505) 722-1487
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1480
(505) 722-1487
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R17387
NM
Other
Enumeration date
08/31/2007
Last updated
08/31/2007
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