Individual
LISA GAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, PSR
Contact information
Practice address
1900 10TH ST, ALAMOGORDO, NM 88310-5053
(575) 437-7404
Mailing address
PO BOX 2267, SANTA FE, NM 87504-2267
(575) 437-4740
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/10/2019
Last updated
05/28/2020
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