Healthcare Provider Details

I. General information

NPI: 1285566778
Provider Name (Legal Business Name): CYNTHIA ESTRADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 MONTANO RD NW
ALBUQUERQUE NM
87107-5030
US

IV. Provider business mailing address

7909 HAVENWOOD CT NW
ALBUQUERQUE NM
87120-4087
US

V. Phone/Fax

Practice location:
  • Phone: 505-344-4427
  • Fax:
Mailing address:
  • Phone: 559-369-8751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number88955
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: