Healthcare Provider Details

I. General information

NPI: 1801855309
Provider Name (Legal Business Name): ANNE CECELIA KESSLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2590 CAMINO ENTRADA
SANTA FE NM
87507-4876
US

IV. Provider business mailing address

2590 CAMINO ENTRADA
SANTA FE NM
87507-4876
US

V. Phone/Fax

Practice location:
  • Phone: 505-946-3233
  • Fax: 505-946-3234
Mailing address:
  • Phone: 505-946-3233
  • Fax: 505-946-3234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number47945
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD2009-0738
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: