Individual
KATHRYN ANN MICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3587
(505) 823-8886
Mailing address
1839 RITA DR NE, ALBUQUERQUE, NM 87106-1131
(505) 321-9060
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R65507
NM
363LF0000X
Family Nurse Practitioner
Primary
53340
NM
Other
Enumeration date
02/09/2017
Last updated
10/24/2019
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