Individual
KATHLEEN K ROEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
649 HARKLE RD, SUITE E, SANTA FE, NM 87505-4765
(505) 955-9411
Mailing address
649 HARKLE RD, SUITE E, SANTA FE, NM 87505-4765
(505) 955-9411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2015-0079
NM
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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