Healthcare Provider Details

I. General information

NPI: 1376545632
Provider Name (Legal Business Name): CATHERINE T. KEMMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 S TRIVIZ DR STE H
LAS CRUCES NM
88001-0601
US

IV. Provider business mailing address

2100 S TRIVIZ DR STE H
LAS CRUCES NM
88001-0601
US

V. Phone/Fax

Practice location:
  • Phone: 505-522-9793
  • Fax: 505-532-9019
Mailing address:
  • Phone: 505-522-9793
  • Fax: 505-532-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number90-61
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: