Individual provider · Type 1 NPI

Stephanie Rae Datema, RN

Emergency Registered Nurse · Gallup, NM

NPI number 1013344779 Active

Practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

PO Box 1337
Gallup, NM 87305-1337

Specialties and licenses

TaxonomyCodeLicense
Emergency Registered Nurse Primary 163WE0003XRN-76978 (NM)

Emergency Registered Nurse: Definition to come...

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About NPI 1013344779

Stephanie Rae Datema, RN's National Provider Identifier is 1013344779, issued on Sep 26, 2013. The primary taxonomy on file is Emergency Registered Nurse (163WE0003X), and the practice location is in Gallup, NM. The record was last updated on Sep 26, 2013.