Organization
JANNA KIPNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA KIPNESS (OWNER)
(505) 820-7562
Entity
Organization
Contact information
Practice address
1448 S SAINT FRANCIS DR, SANTA FE, NM 87505-4038
(505) 820-7562
Mailing address
2560 CAMINO SAN PATRICIO, SANTA FE, NM 87505-5819
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
3188
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B7994
—
NM
Enumeration date
08/16/2017
Last updated
08/16/2017
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