Kristian Cheyenne Antillon
Individual provider Active NPI Case Manager/Care Coordinator · Clovis, NM
NPI 1467061671 · NPPES record last updated Jul 24, 2020
Key facts
- NPI
- 1467061671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1100 W 21St St
Clovis, NM 88101-4151 - Phone
- (575) 769-2345
- NPI assigned
- Jul 24, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1100 W 21St St
Clovis, NM 88101-4151
Mailing address
1100 W 21St St
Clovis, NM 88101-4151
Phone (575) 769-2345
Other providers in Clovis, NM
- Charlene Anaele
- Ronda Renee Anaya
- Sarah Elizabeth Anderson
- Ivone Andrade
- Kynadie Andrews
- Adora Anudu
- Solitaire Apodaca
- Apple Chiropractic Center Inc
- Apria Healthcare LLC
- Lourdes Aragon
All providers in Clovis, NM · Case Manager/Care Coordinator in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.