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Individual

KRISTINE M PARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
510 N GUADALUPE ST STE C1-C2, SANTA FE, NM 87501-6510
(505) 913-4660
Mailing address
510 N GUADALUPE ST STE C1-C2, SANTA FE, NM 87501-6510
(505) 913-4660

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20030112
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10012787
LOVELACE
01
15389
MOLINA
05
16929781
NM
01
202019234
PRESBYTERIAN HEALTH PLANS
01
2362512
UHC
01
NM002A15
BCBS NM
NM
Enumeration date
10/13/2005
Last updated
02/14/2012
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