Individual
JACKOLIN BETH PATES-SWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
900 W ASH ST, DEMING, NM 88030-4000
(575) 544-7361
(575) 544-7221
Mailing address
2801 WATER HAZARD DR SE, DEMING, NM 88030-7357
(316) 641-5594
(575) 544-7361
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R44842
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100247710E
—
KS
05
—
89179510
—
NM
05
—
987951
—
AZ
Enumeration date
06/07/2006
Last updated
08/20/2009
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