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Individual

KEYANNA J CARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3150 CARLISLE BLVD NE STE 105, ALBUQUERQUE, NM 87110-1680
(505) 633-8173
Mailing address
4142 MESA VERDE AVE NE APT 4, ALBUQUERQUE, NM 87110-7789
(505) 850-4212

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
08/08/2022
Last updated
08/24/2022
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