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
| Taxonomy | Code | License |
|---|---|---|
| Emergency Registered Nurse Primary | 163WE0003X | RN-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.