Individual
AMBER LEE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
701 MCCORMICK SCHOOL RD, FARMINGTON, NM 87401-7141
(505) 599-8606
Mailing address
3504 KAYENTA DR, FARMINGTON, NM 87402-5232
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-79452
NM
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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