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1114287216
ERNESTINE CLARK
GALLUP, NM
NPI
1114287216
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NM R47430)
Enumeration Date
2012-05-22
Last Update Date
2012-05-22
Business Address
ERNESTINE CLARK RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
ERNESTINE CLARK RN
PO BOX 1337
GALLUP, NM 87305-1337
Phone number: 505-722-1000
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