| Or Factor | |
|
400 N Pennsylvania Ave Ste 670c Roswell NM 88201-4755 | |
| (575) 420-7336 | |
| (575) 627-5721 |
| Full Name | Or Factor |
|---|---|
| Speciality | Social Worker |
| Location | 400 N Pennsylvania Ave Ste 670c, Roswell, New Mexico |
| Authorized Official Name and Position | Kimberly Shannon Byrne (OWNER) |
| Authorized Official Contact | 5754207336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Or Factor 400 N Pennsylvania Ave Ste 670c Roswell NM 88201-4755 Ph: (575) 623-7336 | Or Factor 400 N Pennsylvania Ave Ste 670c Roswell NM 88201-4755 Ph: (575) 420-7336 |
| NPI Number | 1285177675 |
|---|---|
| Provider Enumeration Date | 12/02/2016 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Medicare PECOS PAC ID | 8325300817 |
|---|---|
| Medicare Enrollment ID | O20180321001267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285177675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kimberly Shannon Byrne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831325828 PECOS PAC ID: 6901040377 Enrollment ID: I20130925000429 |
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