Healthcare Provider Details

I. General information

NPI: 1346534989
Provider Name (Legal Business Name): MEGAN KRISPINSKY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 CERRILLOS RD
SANTA FE NM
87505-3026
US

IV. Provider business mailing address

1700 CERRILLOS RD
SANTA FE NM
87505-3026
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-9821
  • Fax: 505-946-9556
Mailing address:
  • Phone: 505-988-9821
  • Fax: 505-946-9556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA124889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: