Puckett, Kevin Ryan

Puckett, Kevin Ryan is an individual health care provider with primary practice located at 1528 Five Points Rd Sw , Albuquerque NM 87105-3179. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Puckett, Kevin Ryan can be contacted via phone (505) 242-6919.

Contact Information

Primary practice address
1528 Five Points Rd Sw Albuquerque NM 87105-3179
Phone: (505) 242-6919
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X CSA0210841 New Mexico

Profile Details

NPI number 1881207496
LBN Legal business name Puckett, Kevin Ryan
Credentials LSAA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2020
Last updated Aug 25th, 2020 - about 4 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.

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