Ursula Michael Gabriel

Individual provider Active NPI Nurse's Aide · Dulce, NM

NPI 1770809527 · NPPES record last updated Apr 19, 2010

Key facts

NPI
1770809527
Entity type
Individual (NPI type 1)
Primary specialty
Nurse's Aide 376K00000X
License
A026173 (SD)
Practice address
12000 Stone Lake Road
Dulce, NM 87528
Phone
(575) 759-3291
Fax
(575) 759-7294
NPI assigned
Apr 19, 2010
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
A026173SDMDNurse's Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X A026173 SD Yes

Addresses

Primary practice location

12000 Stone Lake Road
Dulce, NM 87528

Mailing address

12000 Stone Lake Road
Dulce, NM 87528
Phone (575) 759-3291

Other providers in Dulce, NM

All providers in Dulce, NM · Nurse's Aide in New Mexico

Sources for this page

Verify at the official NPI Registry.