Individual
JADE EASTON GREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OMD LAC NCCAOM
Contact information
Practice address
2585 AVENIDA DE ISIDRO, SANTA FE, NM 87505-6414
(505) 983-9133
(505) 424-0168
Mailing address
2585 AVENIDA DE ISIDRO, SANTA FE, NM 87505-6414
(505) 983-9133
(505) 424-0168
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
171
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM00R31I
BCBS OF NM
NM
Enumeration date
10/23/2006
Last updated
07/08/2007
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