Individual
MRS. MARY ELOISE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,BSN
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
490 FARM ROAD 1735, MOUNT PLEASANT, TX 75455-8250
(903) 563-4167
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
909730
TX
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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