Gorham, Janet Lee

Gorham, Janet Lee is an individual health care provider with primary practice located at 120 Llano St , Aztec NM 87410-2172. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gorham, Janet Lee can be contacted via phone (505) 334-9441.

Contact Information

Primary practice address
120 Llano St Aztec NM 87410-2172
Phone: (505) 334-9441
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 90898 Oklahoma
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 161890 Montana
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 72100 New Mexico

Profile Details

NPI number 1265604557
LBN Legal business name Gorham, Janet Lee
Credentials APRN-CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2008
Last updated May 9th, 2023 - about last year

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 1265604557 NPPES
Oklahoma MEDICAID 100747570A
Oklahoma MEDICAID 200210930A

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