Healthcare Provider Details

I. General information

NPI: 1689551343
Provider Name (Legal Business Name): DANIELLE NICOLE PINO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2025
Last Update Date: 08/16/2025
Certification Date: 08/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8220 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1602
US

IV. Provider business mailing address

1726 CAMINO RUSTICA SW
LOS LUNAS NM
87031-8122
US

V. Phone/Fax

Practice location:
  • Phone: 505-203-1330
  • Fax:
Mailing address:
  • Phone: 505-203-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN-73083
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: