Sadie M. Benallie, L.P.N.

Individual provider Active NPI Licensed Practical Nurse · Tohatchi, NM

NPI 1679709083 · NPPES record last updated Jun 1, 2009

Key facts

NPI
1679709083
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L04547 (NM)
Practice address
07 Choosgai Drive
Tohatchi, NM 87325
Phone
(505) 733-8150
NPI assigned
Jun 1, 2009
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

State licenses

LicenseStateTypeSpecialty
L04547NMMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L04547 NM Yes

Addresses

Primary practice location

07 Choosgai Drive
Tohatchi, NM 87325

Mailing address

PO Box 1337
Gallup, NM 87305-1337
Phone (505) 733-8150

Other providers in Tohatchi, NM

All providers in Tohatchi, NM · Licensed Practical Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.