Individual
GERREL KEITH-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-3029
Mailing address
PO BOX 28164, SANTA FE, NM 87592-8164
(505) 216-2727
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/30/2024
Last updated
12/01/2025
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