NPI 1053554204

Jillian Marie Beausoleil, IDMT

Practitioner Independent Duty Medical Technicians Cannon Afb, NM

Practice location

Address: 511 N Torch Blvd Rm 102b, Cannon Afb, NM 88103-5109
Phone: (575) 784-0287
Mailing address: 1204 Rosewood Dr, Clovis, NM 88101-9391

Registered specialties

Independent Duty Medical Technicians Primary

Other Service Providers Taxonomy 1710I1003X

Other Military Health Care Provider providers in New Mexico →

Registry record

NPI: 1053554204
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Apr 2009
Record last updated: 6 Oct 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.