Individual
CHERYL HARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
(505) 213-0007
Mailing address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
(505) 213-0007
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L17275
NM
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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