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1871020255
TINA MARIE GONZALES
SANTA FE, NM
NPI
1871020255
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NM CNP-03228)
Enumeration Date
2017-05-17
Last Update Date
2018-03-17
Business Address
TINA MARIE GONZALES
811 SAINT MICHAELS DR
SANTA FE, NM 87505-7641
Phone number: 505-988-2049
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Mailing Address
TINA MARIE GONZALES
166 COUNTY ROAD 119
ESPANOLA, NM 87532-3502
Phone number: 505-501-4408
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