Provider Demographics
NPI:1912989245
Name:LARKIN, KEVIN DOYLE (RN)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:DOYLE
Last Name:LARKIN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 MONTE ALTO RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-8865
Mailing Address - Country:US
Mailing Address - Phone:619-871-4364
Mailing Address - Fax:
Practice Address - Street 1:109 MONTE ALTO RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-8865
Practice Address - Country:US
Practice Address - Phone:619-871-4364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96169101YM0800X
HIMFT-706101YM0800X
CARN423258163W00000X
NMCTB-2022-0209106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse