Provider Demographics
NPI:1699488874
Name:KAISER, PETER KERR (LSAA)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:KERR
Last Name:KAISER
Suffix:
Gender:M
Credentials:LSAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 E SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-3437
Mailing Address - Country:US
Mailing Address - Phone:575-342-8317
Mailing Address - Fax:
Practice Address - Street 1:118 S IRON ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-3628
Practice Address - Country:US
Practice Address - Phone:575-694-5478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)