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1013530278
AMANDA LYNN BROCK
GALLUP, NM
NPI
1013530278
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WE0003X Registered Nurse, Emergency
(Licence: KY 1124383)
Enumeration Date
2020-05-22
Last Update Date
2020-05-22
Business Address
AMANDA LYNN BROCK RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
AMANDA LYNN BROCK RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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