Healthcare Provider Details

I. General information

NPI: 1083015234
Provider Name (Legal Business Name): MARIA CARDENAS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2014
Last Update Date: 01/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 7TH ST SW
ALBUQUERQUE NM
87102-3809
US

IV. Provider business mailing address

511 7TH ST SW
ALBUQUERQUE NM
87102-3809
US

V. Phone/Fax

Practice location:
  • Phone: 415-312-4376
  • Fax:
Mailing address:
  • Phone: 415-312-4376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number824958
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001278
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number02604
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: