Jenna Lindsay Gorman, RN

Individual provider Active NPI School Registered Nurse · Logan, NM

NPI 1255845293 · NPPES record last updated Nov 29, 2017

Key facts

NPI
1255845293
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
RN-81143 (NM)
Practice address
301 N 2ND St
Logan, NM 88426-8842
Phone
(575) 487-2252
Fax
(575) 487-9479
NPI assigned
Nov 29, 2017
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
RN-81143NMMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN-81143 NM Yes

Addresses

Primary practice location

301 N 2ND St
Logan, NM 88426-8842

Mailing address

PO Box 272
Logan, NM 88426-0272
Phone (575) 403-6512

Other providers in Logan, NM

All providers in Logan, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.