Gates, Deitra

Gates, Deitra is an individual health care provider with primary practice located at 610 Broadway Blvd Ne , Albuquerque NM 87102-2372. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Gates, Deitra can be contacted via phone (505) 242-3991.

Contact Information

Primary practice address
610 Broadway Blvd Ne Albuquerque NM 87102-2372
Phone: (505) 242-3991
Fax: (505) 243-8405
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X CNS-00245 New Mexico

Profile Details

NPI number 1366865560
LBN Legal business name Gates, Deitra
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2014
Last updated Jul 21st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366865560 NPPES
New Mexico MEDICAID 97304077

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