Individual
ANGELA M KISNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DOM, FNP-CB, BSN-RN
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5154
(505) 265-1711
Mailing address
9805 RIO CORTO AVE SW, ALBUQUERQUE, NM 87121-2628
(505) 803-3623
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
992
NM
261QV0200X
VA Clinic/Center
54175
NM
363LF0000X
Family Nurse Practitioner
Primary
54175
NM
Other
Enumeration date
06/25/2009
Last updated
03/11/2022
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