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1386201598
MICHELLE LEE JACKSON
GALLUP, NM
NPI
1386201598
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WE0003X Registered Nurse, Emergency
(Licence: TX 577517)
Enumeration Date
2019-05-22
Last Update Date
2019-05-22
Business Address
MICHELLE LEE JACKSON RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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Mailing Address
MICHELLE LEE JACKSON RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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