Organization
CROSS HEART CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MOLLY KENYON APRN-CNP (OWNER PROVIDER)
(575) 355-2273
Entity
Organization
Contact information
Practice address
848 NORTH 4TH STREET, FORT SUMNER, NM 88119-9411
(575) 355-2273
Mailing address
PO BOX 928, FORT SUMNER, NM 88119-0928
(575) 355-2273
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/05/2021
Last updated
10/27/2021
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