Provider Demographics
NPI:1306695788
Name:KWIEK, FRANCES ANN (CCSS)
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:ANN
Last Name:KWIEK
Suffix:
Gender:F
Credentials:CCSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1991
Mailing Address - Street 2:
Mailing Address - City:ELEPHANT BUTTE
Mailing Address - State:NM
Mailing Address - Zip Code:87935-1991
Mailing Address - Country:US
Mailing Address - Phone:575-740-4619
Mailing Address - Fax:
Practice Address - Street 1:800 E 9TH AVE
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-1954
Practice Address - Country:US
Practice Address - Phone:575-894-2111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM9992083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine