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NPI Code Detail

MEDICARE: MIMI KESSINGER

MEDICARE: MIMI KESSINGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant82-PA 007NM

General Provider Information

NPI Number : 1124065834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIMI KESSINGER
Provider Business Mailing Address
First Line : 800 BRADBURY DR SE STE 116
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-4310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2211 LOMAS BLVD NE
Second Line : 5ACC CLINIC D
City : ALBUQUERQUE
State : NM
Zip : 87106-2719
Country : US
Telephone Number : 505-272-3859
Fax Number : 505-272-3737
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 01/28/2026

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Directions to “ MIMI KESSINGER ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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