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1962040832
HALEY JAEY GRANT
LOS LUNAS, NM
NPI
1962040832
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NM 55095)
Enumeration Date
2019-12-11
Last Update Date
2019-12-11
Business Address
HALEY JAEY GRANT
1202 MAIN ST NE
LOS LUNAS, NM 87031-7409
Phone number: 505-565-0070
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Mailing Address
HALEY JAEY GRANT
957 BENJAMIN DR SE
RIO RANCHO, NM 87124-1239
Phone number: 580-630-9500
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