Kenyon, Mary M
Kenyon, Mary M is an sole proprietor health care provider with primary practice located at Cross Heart Care 848 N 4Th St., Fort Sumner NM 88119. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kenyon, Mary M can be contacted via phone (575) 355-2273.Contact Information
Primary practice address
Cross Heart Care 848 N 4Th St.
Fort Sumner NM 88119
Phone: (575) 355-2273
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | CNP-02696 | New Mexico |
Profile Details
| NPI number | 1366824963 |
|---|---|
| LBN Legal business name | Kenyon, Mary M |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 19th, 2015 |
| Last updated | Nov 11th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366824963 | NPPES |
| New Mexico | MEDICAID | 80784275 |
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