Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | A-784-84 | NM |
N | 208D00000X | General Practice Physician | A-784-84 | NM |
NPI | 1396719274 |
---|---|
Provider Name | Ms. Kathleen Edna Maley |
First Address | Albuquerque, NM 87106-1412 |
Second Address | Albuquerque, NM 87106-1412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 03/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40527 | (05) | NM |
E60274 | (02) |