Individual
KIMBERLY FUSSELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
490A W ZIA RD, SANTA FE, NM 87505-6996
(505) 913-8900
Mailing address
2317 DIETZ FARM RD NW, ALBUQUERQUE, NM 87107-3117
(505) 715-0008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2025-0024
NM
Other
Enumeration date
03/06/2025
Last updated
03/06/2025
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