Karen Marie Zezza-Vinyard, LMT
Individual provider Active NPI Contractor · Albuquerque, NM
NPI 1609282144 · NPPES record last updated Jul 4, 2014
Key facts
- NPI
- 1609282144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- MT-20184 (AZ)
- Practice address
- 6540 Ancients Rd NW
Albuquerque, NM 87114-6111 - Phone
- (505) 908-8070
- NPI assigned
- Jul 4, 2014
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MT-20184 | AZ | MD | Contractor |
| 7688 | NM | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | MT-20184 | AZ | Yes |
| Contractor | 171W00000X | 7688 | NM |
Addresses
Primary practice location
6540 Ancients Rd NW
Albuquerque, NM 87114-6111
Mailing address
6540 Ancients Rd NW
Albuquerque, NM 87114-6111
Phone (505) 908-8070
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 4, 2014. 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.