Provider Demographics
NPI:1356331540
Name:CURT, CAL K (CNP)
Entity Type:Individual
Prefix:MR
First Name:CAL
Middle Name:K
Last Name:CURT
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N CORONADO AVE
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-0238
Mailing Address - Country:US
Mailing Address - Phone:505-753-7218
Mailing Address - Fax:505-753-5815
Practice Address - Street 1:211 N PINE
Practice Address - Street 2:
Practice Address - City:CHAMA
Practice Address - State:NM
Practice Address - Zip Code:87520-1005
Practice Address - Country:US
Practice Address - Phone:575-756-2143
Practice Address - Fax:575-756-2821
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP00532363LF0000X
NMR27710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM92866Medicaid
NMNM400320OtherMEDICARE PTAN
NMR12893Medicare UPIN