Mary Melinda Andress, RN

Individual provider Active NPI Emergency Registered Nurse · Gallup, NM

NPI 1063909638 · NPPES record last updated Apr 18, 2018

Key facts

NPI
1063909638
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
R874644 (MS)
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1165
NPI assigned
Apr 18, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R874644MSMDEmergency Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X R874644 MS Yes

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

13 Crestwood Dr
Vicksburg, MS 39180-6243
Phone (601) 218-0100

Other providers in Gallup, NM

All providers in Gallup, NM · Emergency Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.