Individual
JONNA WINN MARION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2000 SUDDERTH DR, RUIDOSO, NM 88345-6119
(806) 592-1060
Mailing address
1202 BELAIRE AVE, DENVER CITY, TX 79323-9547
(806) 215-5564
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
646748
TX
363L00000X
Nurse Practitioner
AP114369
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0082EV
BLUE CROSS/BLUE SHIELD
TX
05
—
137227806
—
TX
05
—
137227810
—
TX
01
—
HH0448
BCBS
TX
Enumeration date
11/03/2005
Last updated
01/01/2019
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