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Individual

MS. DEBORAH POLK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
516 EAST NIZHONI BLVD, GALLUP, NM 87301
(505) 722-1000
(505) 722-1487
Mailing address
516 E. NIZHONI BLVD, GALLUP, NM 87301
(505) 722-1790
(505) 722-1487

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN157409
AZ

Other

Enumeration date
06/11/2009
Last updated
06/11/2012
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