Individual
CRYSTAL GOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
507 S PARK AVE, AZTEC, NM 87410-2253
(505) 334-9469
Mailing address
111 ROAD 3000, AZTEC, NM 87410-9501
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
86330
NM
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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