Kerriann Maria Malott, BSN,RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

59774 Issued in NM

Practice address

325 N Bergin LN
Bloomfield, NM 87413-6729

Phone

(505) 632-4337

Fax

(505) 632-4371

NPI assigned

Aug 4, 2022

Last updated

Aug 4, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659571200000",
    "number": "1083341572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 N BERGIN LN",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874136729",
            "telephone_number": "505-632-4337",
            "fax_number": "505-632-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N BERGIN LN",
            "city": "BLOOMFIELD",
            "state": "NM",
            "postal_code": "874136729",
            "telephone_number": "505-632-4337",
            "fax_number": "505-632-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOTT",
        "first_name": "KERRIANN",
        "middle_name": "MARIA",
        "credential": "BSN,RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-04",
        "last_updated": "2022-08-04",
        "certification_date": "2022-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "NM",
            "license": "59774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie Kiger-Legrand, P.T.A.
• Monika Kos, PH.D.; NCSP
• Michael Kurita
• Mariah Kay Lasley-Miller
• Marichu Lazo, COTA
• Kylie Spencer Mangan
• Jennifer I Martin, MA; CCC-SLP
• Darlene M Martinez, LBSW
• Amy Elizabeth Massey, OTR
• Randy R Maxson

• General Practice Registered Nurse in Bloomfield, NM
• Providers in Bloomfield, NM by specialty
• General Practice Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.