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General NPI Number Information
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NPI Number | 1518675974
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Entity Type | Organization
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Legal Business Name | KM CARES, LLC
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 11/24/2024
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Provider Practice Location Address
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Address Line | 2920 CARLISLE BLVD NE BLDG B
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-2867
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Country | US
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Telephone | 575-973-2364
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Fax |
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Provider Business Mailing Address
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Address Line | 2920 CARLISLE BLVD NE BLDG B
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-2867
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Country | US
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Telephone | 575-973-2364
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KAYLA RUTLEDGE
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Credential |
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Telephone | 505-585-3079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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