Basic Information
| Provider Information | |||||||||
| NPI: | 1023117827 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGURSKI | ||||||||
| FirstName: | KIERSTEN | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LM, CPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 94508 | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871994508 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5053847352 | ||||||||
| FaxNumber: | 5052747338 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 PASEO DEL CANON W STE A | ||||||||
| Address2: | |||||||||
| City: | TAOS | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875716943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5757585857 | ||||||||
| FaxNumber: | 5757585860 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 11/14/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | 00405R | NM | N | Other Service Providers | Midwife | 101YM0800X | 0192321 | NM | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | 201029367 | 01 | NM | PRESBYTERIAN | OTHER | NM006951 | 01 | NM | BLUE CROSS BLUE SHIELD | OTHER | 64481344 | 05 | NM | MEDICAID |