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Individual

KATHY RUTH RAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM, CAC

Contact information

Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 726-8638
Mailing address
1413 RED ROCK DR, GALLUP, NM 87301-5647
(505) 409-7200

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5622
CERTIFIED NURSE MIDWIFE
01
RN0000103139
RN LICENSURE
TN
Enumeration date
03/30/2007
Last updated
10/17/2013
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