Individual
FAIRELYN WILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Mailing address
PO BOX 2790, CHINLE, AZ 86503-2790
(928) 380-7845
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN213178
AZ
163WP0200X
Pediatric Registered Nurse
95129067
CA
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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