Healthcare Provider Details

I. General information

NPI: 1225620016
Provider Name (Legal Business Name): MICHAEL KESNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2021
Last Update Date: 07/21/2022
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038 MCEU-BAV-CRE, APO, AE
STUTTGART BADEN-WRTTEMBERG
09112
DE

IV. Provider business mailing address

US ARMY MEDICAL ACTIVITY-BAVARIA UNIT 28038 ATTN: MCEU-BAV-CRE, APO, AE
STUTTGART BADEN-WRTTEMBERG
09112
DE

V. Phone/Fax

Practice location:
  • Phone: 505-220-8749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number85050
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: