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Individual

JAN KRISTY COLANZE SENERICHES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
400 NELSON AVE APT 1105, FARMINGTON, NM 87401-3335
(505) 436-9688
Mailing address
400 NELSON AVE APT 1105, FARMINGTON, NM 87401-3335
(505) 436-9688

Taxonomy

Speciality
Code
Description
License number
State
163WN0300X
Nephrology Registered Nurse
Primary
RN-84262
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1132003
NM
Enumeration date
02/24/2022
Last updated
02/24/2022
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