Individual
TINA MARIE GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
811 SAINT MICHAELS DR, SANTA FE, NM 87505-7641
(505) 988-2049
(505) 992-2930
Mailing address
166 COUNTY ROAD 119, ESPANOLA, NM 87532-3502
(505) 501-4408
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-03228
NM
Other
Enumeration date
05/17/2017
Last updated
03/17/2018
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