Verna Ann Kenneth, BA, LSAA, CMS

Individual provider Active NPI Case Manager/Care Coordinator · Crownpoint, NM

NPI 1972893436 · NPPES record last updated Apr 18, 2011

Key facts

NPI
1972893436
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
0138591 (NM)
Practice address
North 371 Southwest Highland Drive
Crownpoint, NM 87313
Phone
(505) 786-2111
Fax
(505) 786-5442
NPI assigned
Apr 18, 2011
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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
0138591NMMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 0138591 NM
Case Manager/Care Coordinator 171M00000X 0138591 NM Yes

Addresses

Primary practice location

North 371 Southwest Highland Drive
Crownpoint, NM 87313

Mailing address

Box 1144
Southwest Highland Drive
Crownpoint, NM 87313-1144
Phone (505) 786-2111

Other identifiers

IdentifierTypeStateIssuer
1831397488OtherNMBHS

Other providers in Crownpoint, NM

All providers in Crownpoint, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.