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NPI Code Detail

MEDICARE: MRS. KAILEY VISOSKI PEARCE MSBE

MEDICARE: MRS. KAILEY VISOSKI PEARCE MSBE
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 AssistantPA2026-0007NM

General Provider Information

NPI Number : 1619785052
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAILEY VISOSKI PEARCE MSBE
Provider Business Mailing Address
First Line : 933 BRADBURY DR SE STE 2222
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-4375
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2211 LOMAS BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2719
Country : US
Telephone Number : 505-272-2111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2024
Last Update Date : 02/18/2026

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