Provider Demographics
NPI:1801855309
Name:KESSLER, ANNE CECELIA (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:CECELIA
Last Name:KESSLER
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 1:2590 CAMINO ENTRADA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-4876
Mailing Address - Country:US
Mailing Address - Phone:505-946-3233
Mailing Address - Fax:505-946-3234
Practice Address - Street 1:2590 CAMINO ENTRADA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-4876
Practice Address - Country:US
Practice Address - Phone:505-946-3233
Practice Address - Fax:505-946-3234
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47945208000000X
NMMD2009-0738208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ451766Medicaid
NM000Z0541Medicaid
MTFK0416784OtherDEA
COC305916Medicare PIN