Individual
KAREN PETTIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
343 MAIN ST NW, LOS LUNAS, NM 87031-8712
(505) 869-2679
Mailing address
343 MAIN ST NW, LOS LUNAS, NM 87031-8712
(505) 869-2679
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R61844
NM
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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