Healthcare Provider Details

I. General information

NPI: 1881539856
Provider Name (Legal Business Name): IKANDY METHOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 OSUNA RD NE STE E
ALBUQUERQUE NM
87113-1084
US

IV. Provider business mailing address

585 OSUNA RD NE STE E
ALBUQUERQUE NM
87113-1084
US

V. Phone/Fax

Practice location:
  • Phone: 505-205-2727
  • Fax:
Mailing address:
  • Phone: 505-205-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTYN CORDOVA
Title or Position: OWNER/PROVIDER
Credential: CNP
Phone: 505-307-8449