Individual
KAREN DEGENEVIEVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1313 E 32ND ST, SILVER CITY, NM 88061-7251
(575) 538-4009
(575) 538-4003
Mailing address
1313 E 32ND ST, SILVER CITY, NM 88061-7251
(575) 538-4009
(575) 538-4003
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R28079
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000Z1351
—
NM
01
—
342653YMKS
MEDICARE PTAN
NM
01
—
NM301740
MEDICARE PTAN
—
05
—
Z13151
—
NM
Enumeration date
10/24/2006
Last updated
02/10/2016
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