Healthcare Provider Details

I. General information

NPI: 1558882910
Provider Name (Legal Business Name): MS. NORMA KARRAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W MALONEY AVE STE 208
GALLUP NM
87301-3325
US

IV. Provider business mailing address

1300 W MALONEY AVE STE 208
GALLUP NM
87301-3325
US

V. Phone/Fax

Practice location:
  • Phone: 505-269-9099
  • Fax: 505-726-2871
Mailing address:
  • Phone: 505-269-9099
  • Fax: 505-726-2871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: