Kaitlyn Therese Archibeque

Individual provider Active NPI Athletic Trainer · Algodones, NM

NPI 1750837332 · NPPES record last updated Sep 1, 2016

Key facts

NPI
1750837332
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
1370A Hwy 313
Algodones, NM 87001
Phone
(505) 414-4565
NPI assigned
Sep 1, 2016
Sex
Female
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)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

1370A Hwy 313
Algodones, NM 87001

Mailing address

P.O. Box 716
Algodones, NM 87001
Phone (505) 414-4565

Other providers in Algodones, NM

All providers in Algodones, NM · Athletic Trainer in New Mexico

Sources for this page

Verify at the official NPI Registry.