Cecelia Bodiford

Individual provider Active NPI Emergency Registered Nurse · Gallup, NM

NPI 1962942276 · NPPES record last updated Mar 6, 2017

Key facts

NPI
1962942276
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
RN077345 (GA)
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1000
NPI assigned
Mar 6, 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

State licenses

LicenseStateTypeSpecialty
RN077345GAMDEmergency Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN077345 GA Yes

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

516 E Nizhoni Blvd
Gallup, NM 87301-5748

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.