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Contact Information

RAELYNN BENALLY
2111 COLLEGE DR
GALLUP, NM87301-5600
 Phone: 505-397-5172
 Fax: 877-396-1184
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for RAELYNN BENALLY · (Female)

NPI Number 1053855593
Status Active
Credentials
Entity Individual
Enumeration date 12/16/2016
Last updated 01/28/2026 - About 4 months ago
Sole proprietor 1 Yes
Identifiers
  • NM License # 85128
  • NM License # RN-75921
  • NM Medicaid N0011073
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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