Individual
KATHY LYNN WIRZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA, NM 87532-2724
(518) 481-8000
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(573) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
345173
NY
363L00000X
Nurse Practitioner
Primary
57115
NM
363LF0000X
Family Nurse Practitioner
2019014886
MO
Other
Enumeration date
05/22/2019
Last updated
11/03/2022
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