Katherine E Mallion, PA-C, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

94PA26 Issued in NM

Practice address

1511 S Grand Ave
Roswell, NM 88203-5407

Phone

(575) 623-3255

Fax

(575) 625-9901

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Physician Assistant

State licenses

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1831180405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W FIR ST",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881305703",
            "telephone_number": "575-356-6695",
            "fax_number": "575-356-5948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 S GRAND AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882035407",
            "telephone_number": "575-623-3255",
            "fax_number": "575-625-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLION",
        "first_name": "KATHERINE",
        "middle_name": "E",
        "credential": "PA-C, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "94PA26",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NM",
            "license": "CNP00188",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91544",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Macias
• Margarita Reloza Macias, M.D.
• James Douglas Macqueen, D.O.
• Truett Layton Maddox, MD
• Daria Maghsoudlou
• Haden Gregory Maloney
• Nyahsia Mandonado
• David E Mansfield, MD
• Meghan Manzanares
• Lonna Kay Mapes, MS CCC-SLP

• Nurse Practitioner in Roswell, NM
• Providers in Roswell, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; 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.