Individual
ROGER LOUIS GAVI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3604 CAMEO DR SE, ALBUQUERQUE, NM 87105-0204
(505) 340-1171
Mailing address
3604 CAMEO DR SE, ALBUQUERQUE, NM 87105-0204
(505) 340-1171
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
R59159
NM
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
R59159
NM
Other
Enumeration date
01/28/2010
Last updated
01/28/2010
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