Individual
KACEE CHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 DR MARTIN LUTHER KING JR AVE NE STE 301, ALBUQUERQUE, NM 87102-3668
(505) 727-7090
Mailing address
4101 INDIAN SCHOOL RD NE STE 110, ALBUQUERQUE, NM 87110-3991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
80267
NM
Other
Enumeration date
08/19/2024
Last updated
10/29/2025
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