Healthcare Provider Details

I. General information

NPI: 1811822398
Provider Name (Legal Business Name): MRS. CINDY KIMBERLY GREETAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CJ GREETAN

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8134 SAND SPRINGS CIR NW
ALBUQUERQUE NM
87114-6087
US

IV. Provider business mailing address

8134 SAND SPRINGS CIR NW
ALBUQUERQUE NM
87114-6087
US

V. Phone/Fax

Practice location:
  • Phone: 575-650-5896
  • Fax:
Mailing address:
  • Phone: 575-650-5896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number71516
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: