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General NPI Number Information
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NPI Number | 1013058353
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Entity Type | Individual
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Provider Name | JANA GUNNELL M.D., M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1919 COLLEGE DR
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City | GALLUP
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State | NM
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Zip | 87301-7010
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Country | US
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Telephone | 505-863-4572
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Fax | 505-722-3134
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Provider Business Mailing Address
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Address Line | 1204 PINON LN
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City | GALLUP
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State | NM
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Zip | 87301-5646
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 84-45
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License Number State | NM
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