Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kennedy M Zaccheo, PA

Individual provider Physician Assistant · NPI 1417538117

Kennedy M Zaccheo, PA is a Physician Assistant in Albuquerque, New Mexico. Practices as a sole proprietor. Licensed in New Mexico.

Licensed in
NM
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2100 Louisiana Blvd NE Ste 410
Albuquerque, NM 87110-5412
Phone: (505) 724-4300
Fax: (505) 724-4300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA2022-0056 (NM)

Record details

NPI number1417538117
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedApril 15, 2021
Last updated in NPPESOctober 13, 2022
Certification dateOctober 13, 2022

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