Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2003020150 | MO |
N | 2080P0214X | Pediatric Pulmonologist | 2003020150 | MO |
NPI | 1417122862 |
---|---|
Provider Name | Dr. Audrey Wells Gurule |
First Address | Albuquerque, NM 87109-3489 |
Second Address | Burnsville, MN 55337-2537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2008 |
Last Update Date | 23/09/2020 |