NPI 1861887192 · live from the CMS NPI Registry
Kresta S Antillon
Family Medicine in Los Lunas, NM. National Provider Identifier 1861887192, active.
NPI record
| NPI | 1861887192 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 145 Don Pasqual Rd Nw, Los Lunas, NM 87031 |
| Practice phone | 505-865-4618 |
| Mailing address | Msc 09 5040, 1 University Of New Mexico, Albuquerque, NM 87131 |
| Enumerated | April 2, 2015 |
| Last updated | April 26, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | MD2018-0733 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.