Provider Demographics
NPI:1952426553
Name:SENA, KIMBERLY MONICA (DNP, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:MONICA
Last Name:SENA
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:SERAFINA
Mailing Address - State:NM
Mailing Address - Zip Code:87569-0074
Mailing Address - Country:US
Mailing Address - Phone:505-454-5191
Mailing Address - Fax:505-454-5148
Practice Address - Street 1:700 FRIEDMAN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4231
Practice Address - Country:US
Practice Address - Phone:505-454-5191
Practice Address - Fax:505-454-5148
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-05137104100000X
NM67152363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1952426553Medicaid