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Individual

MELISSA CHRISTIANSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN BSN

Contact information

Practice address
550 ROAD 6100, KIRTLAND, NM 87417-9317
(505) 598-5881
Mailing address
9 ROAD 6193, KIRTLAND, NM 87417-9328
(505) 486-9020

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
291090
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
291090
NEW MEXICO PUBLIC EDUCATION DEPARTMENT
NM
01
543567
REGISTERED NURSE
NM
Enumeration date
01/08/2019
Last updated
01/08/2019
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