STEPHANIE RAE DATEMA

GALLUP, NM
NPI1013344779
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy163WE0003X Registered Nurse, Emergency
(Licence: NM  RN-76978)
Enumeration Date2013-09-26
Last Update Date2013-09-26
Business Address
Mrs. STEPHANIE RAE DATEMA RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
Mailing Address
Mrs. STEPHANIE RAE DATEMA RN
PO BOX 1337
GALLUP, NM 87305-1337
Phone number: 505-722-1165
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