Provider Demographics
NPI:1255497855
Name:NIGHBERT, KATHY S MOSMAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:S MOSMAN
Last Name:NIGHBERT
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:7200 MONTGOMERY BLVD NE
Mailing Address - Street 2:#194
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1510
Mailing Address - Country:US
Mailing Address - Phone:505-259-8140
Mailing Address - Fax:505-883-2924
Practice Address - Street 1:7200 MONTGOMERY BLVD NE
Practice Address - Street 2:#194
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1510
Practice Address - Country:US
Practice Address - Phone:505-259-8140
Practice Address - Fax:505-883-2924
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
NM3066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM73920304Medicaid
NM62725203OtherDDW