Provider Demographics
NPI:1518026590
Name:JARRIN, ILEANA LEONOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ILEANA
Middle Name:LEONOR
Last Name:JARRIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:516 NIZHONI BLVD
Mailing Address - Street 2:GALLUP INDIAN MEDICAL CENTER
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87301-5748
Mailing Address - Country:US
Mailing Address - Phone:505-722-1000
Mailing Address - Fax:505-726-8557
Practice Address - Street 1:516 NIZHONI BLVD
Practice Address - Street 2:GALLUP INDIAN MEDICAL CENTER
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5748
Practice Address - Country:US
Practice Address - Phone:505-722-1000
Practice Address - Fax:505-726-8557
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2009-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY231909207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine