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Individual

MARY M KENYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
CROSS HEART CARE, 848 N 4TH ST., FORT SUMNER, NM 88119
(575) 355-2273
Mailing address
PO BOX 928, FORT SUMNER, NM 88119-0928
(575) 355-2273

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02696
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
80784275
NM
Enumeration date
06/19/2015
Last updated
11/11/2021
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