Individual
KIMBERLY WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCSS
Contact information
Practice address
43G PINSBAARI DR, PUEBLO OF ACOMA, NM 87034-1001
(505) 552-5145
(505) 552-5196
Mailing address
PO BOX 333, PUEBLO OF ACOMA, NM 87034-0333
(505) 552-5145
(505) 552-5196
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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