Individual
KENNETH BRADLEY CHIPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
4801 N BUTLER AVE, FARMINGTON, NM 87401-6002
(505) 327-0002
Mailing address
3500 ALTA VISTA DR, FARMINGTON, NM 87402-8810
(505) 573-2723
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
80060
NM
Other
Enumeration date
07/20/2024
Last updated
07/20/2024
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