Provider Demographics
NPI:1487217782
Name:M&K HEALTH CARE CLINICS LLC
Entity Type:Organization
Organization Name:M&K HEALTH CARE CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:505-867-4377
Mailing Address - Street 1:4351 JAGER DR NE STE C
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-7527
Mailing Address - Country:US
Mailing Address - Phone:505-867-4377
Mailing Address - Fax:505-485-0555
Practice Address - Street 1:4351 JAGER DR NE STE C
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-7527
Practice Address - Country:US
Practice Address - Phone:505-867-4377
Practice Address - Fax:505-485-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty