Kennedy, Guadalupe M

Kennedy, Guadalupe M is an individual health care provider with primary practice located at 1515 W Fir St , Portales NM 88130-5703. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Kennedy, Guadalupe M can be contacted via phone (575) 356-6695.

Contact Information

Primary practice address
1515 W Fir St Portales NM 88130-5703
Phone: (575) 356-6695
Fax: (575) 356-5948
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R30564 New Mexico

Profile Details

NPI number 1598756264
LBN Legal business name Kennedy, Guadalupe M
Credentials Certified Family Nurse Practitioner (CFNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jul 12th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598756264 NPPES
New Mexico MEDICAID 25484052

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