Individual
DR. PHYLLIS NADINE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC, BSN-RN
Contact information
Practice address
219 WASHINGTON AVENUE, SANTA FE, NM 87501-1926
(505) 946-7677
(505) 986-1569
Mailing address
121 CAMINO ENCANTADO, SANTA FE, NM 87501-1039
(505) 946-7677
(505) 986-1569
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
1318
NM
111NR0400X
Rehabilitation Chiropractor
4766
CO
111NR0400X
Rehabilitation Chiropractor
DC-29335
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12395202
MULTIPLAN
NM
01
—
5657319
FIRST HEALTH
NM
01
—
693017
ACN GROUP
NM
01
—
876338000
REGENCE BCBS OREGON
OR
01
—
9408737
PRIVATE HEALTHCARE SYSTEM
NM
01
—
NM00KL98
BLUE CROSS BLUE SHIELD NM
NM
Enumeration date
12/15/2006
Last updated
03/10/2015
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