Individual
KIMBERLY MARIE COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 REDROCK DR, GALLUP, NM 87301-5682
(505) 863-7200
Mailing address
1901 REDROCK DR, PFS DEPT, GALLUP, NM 87301-5683
(505) 863-7000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2003-0466
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10005144
LOVELACE HEALTH/SALUD
NM
01
—
201042791
PRESBYTERIAN HEALTH/SALUD
NM
05
—
54580251
—
NM
01
—
809824
AHCCCS
AZ
01
—
850313268020
CHAMPUS
—
01
—
NM009H62
BC/BS
NM
01
—
P00060931
RAILROAD MEDICARE
—
01
—
PROVP12196
MOLINA
NM
Enumeration date
01/06/2006
Last updated
01/04/2023
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