Provider Demographics
NPI:1831304047
Name:VOIGT, KATHLEEN C
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:C
Last Name:VOIGT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:C
Other - Last Name:VOIGT-DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:5504 MENAUL BLVD NE STE F
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3184
Mailing Address - Country:US
Mailing Address - Phone:505-348-2868
Mailing Address - Fax:505-348-2867
Practice Address - Street 1:6701 JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-727-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN129543363L00000X
CA17031363L00000X
NMCNP-01997363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1176490001Medicare NSC
AZS59850Medicare UPIN
AZ101981Medicare PIN