Individual
ANITA MARIE GAUTREAUX
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
22574 3RD ST, MANDEVILLE, LA 70471-7950
(985) 259-3583
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
140234
LA
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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