Healthcare Provider Details

I. General information

NPI: 1407542491
Provider Name (Legal Business Name): LINDSEY KANNO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8080 ACADEMY RD NE STE C
ALBUQUERQUE NM
87111-1110
US

IV. Provider business mailing address

8080 ACADEMY RD NE STE C
ALBUQUERQUE NM
87111-1110
US

V. Phone/Fax

Practice location:
  • Phone: 505-247-4164
  • Fax:
Mailing address:
  • Phone: 505-247-4164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD2026-0006
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: