IndividualActive
Mark Wilson
NPI 1902091937 · Ambulatory Care Registered Nurse · Gallup, NM
Provider details
- NPI number
- 1902091937
- Entity type
- Individual
- Primary specialty
- Ambulatory Care Registered NurseNursing Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- R41887 (NM)
Specialties & taxonomies
Nursing Service Providers
Practice location
516 Nizhoni Blvd
Gallup, NM 87301-5748
Phone: (505) 722-1000
Fax: (505) 722-1310
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1337
Gallup, NM 87305-1337
Registry dates
- Enumerated
- 2007-09-12
- Last updated
- 2007-09-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.