Individual
MRS. EUNICE ANNAZBAH MUSKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
520 HIGHWAY 564, GALLUP VA CBOC, GALLUP, NM 87301
(505) 722-7334
(505) 863-6078
Mailing address
520 HIGHWAY 564, GALLUP VA CBOC, GALLUP, NM 87301
(505) 722-7334
(505) 863-6078
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4400
AZ
363A00000X
Physician Assistant
Primary
PA2005-0010
NM
363AM0700X
Medical Physician Assistant
PA2005-0010
NM
Other
Enumeration date
05/13/2009
Last updated
08/04/2011
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