Fern S. Detsoi

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R17387 Issued in NM

Practice address

516 Nizhoni Blvd
Gallup, NM 87301-5748

Phone

(505) 722-1480

Fax

(505) 722-1487

NPI assigned

Aug 31, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1659565711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1480",
            "fax_number": "505-722-1487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1480",
            "fax_number": "505-722-1487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETSOI",
        "first_name": "FERN",
        "middle_name": "S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R17387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dental Innovations of Gallup
• Kimberly Dawn Denton, RN
• Nick A Desantis
• Daisy Descheene, LPC
• Desert Horizon Transport LLC
• Brande-Jo Deutsawe
• Desiderio Jay Dez, RN
• DHHS, PHS, Naihs, Gallup Indian Medical Center
• DHHS,PHS,Naihs, Gallup Indian Medical Center
• DHHS,PHS,Naihs,Gallup Indian Medical Center

• All providers in Gallup, NM
• Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.