Individual
DAISY ROXANNE TRUJILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
208 GUACHPANGUE RD, ESPANOLA, NM 87532-3424
(505) 747-8187
(505) 747-8306
Mailing address
208 GUACHPANGUE RD, ESPANOLA, NM 87532-3424
(505) 747-8187
(505) 747-8306
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L19499
NM
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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