Karen Griest

Individual provider Active NPI General Practice Physician · Cedar Crest, NM

NPI 1033568902 · NPPES record last updated Jun 10, 2016

Key facts

NPI
1033568902
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
86-239 (NM)
Practice address
68 Pinon TRL
Cedar Crest, NM 87008-9444
Phone
(505) 228-5550
NPI assigned
Jun 10, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
86-239NMMDGeneral Practice Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 86-239 NM Yes

Addresses

Primary practice location

68 Pinon TRL
Cedar Crest, NM 87008-9444

Mailing address

68 Pinon TRL
Cedar Crest, NM 87008-9444
Phone (505) 228-5550

Other providers in Cedar Crest, NM

All providers in Cedar Crest, NM · General Practice Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.