Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 8361 | NM |
NPI | 1013093707 |
---|---|
Provider Name | Mrs. Snehalatha Kankanala |
First Address | Hobbs, NM 88240 |
Second Address | Hobbs, NM 88240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00020412 | (05) | NM |
C97877 | (02) |