Individual
MS. SUSAN H. KAZMIERSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
3396 STATE ROAD 96,, COYOTE, NM 87012-0040
(575) 638-5487
(575) 638-9123
Mailing address
PO BOX 158, 538 N. PASEO DE ONATE, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 753-5815
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP00503
NM
363LF0000X
Family Nurse Practitioner
R26380
NM
367A00000X
Advanced Practice Midwife
422
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92197
—
NM
01
—
NM400323
MEDICARE PTAN
NM
Enumeration date
08/31/2005
Last updated
07/01/2013
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