Provider Demographics
NPI:1083855399
Name:FELT, KARY M (CNP)
Entity type:Individual
Prefix:MR
First Name:KARY
Middle Name:M
Last Name:FELT
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ENTERPRISE RD
Mailing Address - Street 2:
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-4199
Mailing Address - Country:US
Mailing Address - Phone:575-835-4444
Mailing Address - Fax:505-443-8336
Practice Address - Street 1:1300 ENTERPRISE RD
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-4199
Practice Address - Country:US
Practice Address - Phone:575-835-4444
Practice Address - Fax:505-443-8336
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily