| Doctor Name: | JESSICA DALTON |
| NPI Number: | 1245602127 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R66047 |
| Business Practice Address: | 538 County Road 6100 Kirtland, NM - 874179317 |
| Business Phone Number: | 5055986114 |
| Business Fax Number: | 5055989562 |
| Mailing Address: | 538 County Road 6100, KIRTLAND |
| State: | NM |
| Postal Code: | 874179317 |
| Phone Number: | 5055986114 |
| Fax Number: | 5055989562 |
| NPI Enumeration Date: | 10/30/2015 |
| NPI Last Update Date: | 10/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | R66047 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |