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Individual

SUSAN E KINNEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1100 LEAD AVE SE, ALBUQUERQUE, NM 87106-5215
(505) 224-7000
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
66688
NM
363LF0000X
Family Nurse Practitioner
335607
NY

Other

Enumeration date
07/15/2008
Last updated
05/03/2022
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