Individual
KENNETH PAUL SPART JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111
Mailing address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(501) 548-1983
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
23710
TN
363L00000X
Nurse Practitioner
Primary
65612
NM
363LF0000X
Family Nurse Practitioner
23710
TN
Other
Enumeration date
03/02/2018
Last updated
06/22/2023
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