Healthcare Provider Details

I. General information

NPI: 1467366765
Provider Name (Legal Business Name): KIMBERLY ANN FOX MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W MAPLE ST
FARMINGTON NM
87401-5630
US

IV. Provider business mailing address

5005 GREENWOOD DR
FARMINGTON NM
87402-4883
US

V. Phone/Fax

Practice location:
  • Phone: 505-609-2913
  • Fax:
Mailing address:
  • Phone: 505-801-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: