Individual
ETHELINDA W BENALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
US HWY 491 N, NORTHERN NAVAJO MEDICAL CENTER, SHIPROCK, NM 87420
(505) 368-7405
(505) 368-7416
Mailing address
PO BOX 160, ATTN: PHN, SHIPROCK, NM 87420-0160
(505) 368-7405
(505) 368-7416
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
R48677
NM
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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