Individual provider · Type 1 NPI

Jacqueline Alisia Violet Bennett, RN

Registered Nurse · Gallup, NM

NPI number 1619830619 Active

Practice location

345 Basileo Dr
Gallup, NM 87301-4655

Fax (505) 721-1899

Specialties and licenses

Taxonomy	Code	License
Registered Nurse Primary	163W00000X	64532 (NM)

Registered Nurse: (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.'s assist patient…

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About NPI 1619830619

Jacqueline Alisia Violet Bennett, RN's National Provider Identifier is 1619830619, issued on Dec 5, 2025. The primary taxonomy on file is Registered Nurse (163W00000X), and the practice location is in Gallup, NM. The record was last updated on Dec 5, 2025.