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1174068068
MARISSA STARK
GALLUP, NM
NPI
1174068068
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: NM 81165)
Enumeration Date
2016-12-30
Last Update Date
2016-12-30
Business Address
Mrs. MARISSA STARK
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
Mrs. MARISSA STARK
PO BOX 1337
GALLUP, NM 87305-1337
Phone number:
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