Individual
GLORETHA S. WILCOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
711 MAIN PUEBLO ROAD, PUEBLO OF SAN FELIPE, NM 87001
(505) 771-0976
Mailing address
P.O. BOX 4339, PUEBLO OF SAN FELIPE, NM 87001
(505) 771-0976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
03135
NM
363LF0000X
Family Nurse Practitioner
03135
NM
Other
Enumeration date
10/10/2007
Last updated
12/28/2021
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