Individual provider · NPI-1

Tanya Gallegos, CFNP

Nurse Practitioner, Family · Espanola, NM

NPI number1417233107
StatusActive
Last updated in NPPESOct 26, 2011

Details

NPI
1417233107
Entity type
Individual (NPI-1)
Name
Tanya Gallegos
Credential
CFNP
Sex
Female
Sole proprietor
No
Enumeration date
Oct 26, 2011
Last updated
Oct 26, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyCNP-01877NMYes

Practice location

1010 Spruce St
Espanola, NM 87532-2724

Phone 505-753-7111

Mailing address

1010 Spruce St
Espanola, NM 87532-2724

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