Provider Demographics
NPI:1376545632
Name:KEMMER, CATHERINE T (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:T
Last Name:KEMMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 S TRIVIZ DR
Mailing Address - Street 2:STE H
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-0601
Mailing Address - Country:US
Mailing Address - Phone:505-522-9793
Mailing Address - Fax:505-532-9019
Practice Address - Street 1:2100 S TRIVIZ DR
Practice Address - Street 2:STE H
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-0601
Practice Address - Country:US
Practice Address - Phone:505-522-9793
Practice Address - Fax:505-532-9019
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM90-61207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM010415OtherBCBS
NM18784OtherPRES
NM6303493OtherLOVELACE
NM28332Medicaid
NME62049Medicare UPIN