Individual provider · Type 1 NPI

Marisol Villacis

Pediatric Registered Nurse · Gallup, NM

NPI number 1306461306 Active

Practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

15105 SW 109th St
Miami, FL 33196-4347

Specialties and licenses

TaxonomyCodeLicense
Pediatric Registered Nurse Primary 163WP0200X9256240 (FL)

Pediatric Registered Nurse: Definition to come...

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About NPI 1306461306

Marisol Villacis's National Provider Identifier is 1306461306, issued on Jun 15, 2020. The primary taxonomy on file is Pediatric Registered Nurse (163WP0200X), and the practice location is in Gallup, NM. The record was last updated on Jun 15, 2020.