Provider Demographics
NPI:1225124381
Name:KANE, MARCENE ELLYN (CPC)
Entity Type:Individual
Prefix:MRS
First Name:MARCENE
Middle Name:ELLYN
Last Name:KANE
Suffix:
Gender:F
Credentials:CPC
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 810
Mailing Address - Street 2:
Mailing Address - City:MESCALERO
Mailing Address - State:NM
Mailing Address - Zip Code:88340-0810
Mailing Address - Country:US
Mailing Address - Phone:505-464-2902
Mailing Address - Fax:
Practice Address - Street 1:318 ABALONE LOOP
Practice Address - Street 2:MESCALERO INDIAN HOSPITAL
Practice Address - City:MESCALERO
Practice Address - State:NM
Practice Address - Zip Code:88340
Practice Address - Country:US
Practice Address - Phone:505-464-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM246YC3301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Hospital Based