Most Relevant Information
Provider Data
| NPI Number: | 1003473679 |
| Provider Name: | AMY JOALYCE DEJESUS RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WE0003X |
| Specialty: | Registered Nurse |
| License Number: | R90507 |
Most Important Dates
| Enumeration Date: | 05/20/2019 |
| Last Updated: | 05/20/2019 |
Provider Practice Location
516 E NIZHONI BLVD
GALLUP
NM
873015748
Practice Location Phone/Fax
| Phone: | 5057222554 |
| Fax: |
Provider Mailing Location
1320 HEART RD
GLENCOE
AR
725399504
Provider Mailing Phone/Fax
| Phone: | 8702732595 |
| Fax: |