MEDICARE: DR. KIRSTEN LAVISTA DN

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
1	172P00000X	Naprapath

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649499543	OTHER	NM	NAPRAPATHY

General Provider Information

NPI Number	:	1710025648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIRSTEN LAVISTA DN

Provider Business Mailing Address
First Line	:	2006 BOTULPH RD STE A
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-5764
Country	:	US
Telephone Number	:	505-424-8990
Fax Number	:	505-424-6377

Provider Business Practice Location Address
First Line	:	3600 CERRILLOS RD
Second Line	:	SUITE 407
City	:	SANTA FE
State	:	NM
Zip	:	87507-2612
Country	:	US
Telephone Number	:	505-424-8990
Fax Number	:	505-424-6377

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/16/2025

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Directions to “ DR. KIRSTEN LAVISTA DN” Practice Location

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