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1033456686
JACKIE L BERKLEY
GALLUP, NM
NPI
1033456686
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: IL 041270126)
Enumeration Date
2013-01-15
Last Update Date
2013-01-15
Business Address
JACKIE L BERKLEY RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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Mailing Address
JACKIE L BERKLEY RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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