Jordanna Leigh Gurule
Individual provider Active NPI Community/Behavioral Health Agency · T Or C, NM
NPI 1063244259 · NPPES record last updated Aug 15, 2024
Key facts
- NPI
- 1063244259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Practice address
- 312 N Broadway St
T Or C, NM 87901-2834 - Phone
- (575) 740-7219
- NPI assigned
- Aug 15, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
312 N Broadway St
T Or C, NM 87901-2834
Mailing address
49 Snake Springs Rd
Caballo, NM 87931-8004
Phone (575) 740-7219
Other providers in T Or C, NM
- Alexis V Diorio
- Katharine May Elverum
- Patrick Ercolino
- Deanne Fluitt
- Michele Foss
- Klanese Krystal Hatley
- Hazen'S Mental Health
- Cynthia Henry
- Kimberly A Hill
- Joi Holsapple
All providers in T Or C, NM · Community/Behavioral Health Agency in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.