Healthcare Provider Details

I. General information

NPI: 1902044019
Provider Name (Legal Business Name): LEANN CURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 E HIGHWAY 66
GALLUP NM
87301-4868
US

IV. Provider business mailing address

P.O. BOX 971
JAMESTOWN NM
87347-0971
US

V. Phone/Fax

Practice location:
  • Phone: 505-863-6380
  • Fax: 505-863-6370
Mailing address:
  • Phone: 505-863-6380
  • Fax: 505-863-6370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: