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Contact Information

PHYLLIS NADINE GONZALES, DC, BSN-RN
219 WASHINGTON AVENUE
SANTA FE, NM87501-1926
 Phone: 505-946-7677
 Fax: 505-986-1569
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Rehabilitation

111NR0400X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for PHYLLIS NADINE GONZALES · (Female)

NPI # 1821150756
Status Active
Credentials DC, BSN-RN
Entity Individual
Enumeration date 12/15/2006
Last updated 03/10/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # DC-29335
  • CO License # 4766
  • NM License # 1318
  • NM Other 693017 ACN GROUP
  • NM Other NM00KL98 BLUE CROSS BLUE SHIELD NM
  • NM Other 5657319 FIRST HEALTH
  • NM Other 12395202 MULTIPLAN
  • NM Other 9408737 PRIVATE HEALTHCARE SYSTEM
  • OR Other 876338000 REGENCE BCBS OREGON
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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