Healthcare Provider Details

I. General information

NPI: 1619451994
Provider Name (Legal Business Name): ABQHEALTHCARE2YOU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 VIRGINIA ST NE STE C
ALBUQUERQUE NM
87110-4695
US

IV. Provider business mailing address

2509 VIRGINIA ST NE STE C
ALBUQUERQUE NM
87110-4695
US

V. Phone/Fax

Practice location:
  • Phone: 505-658-4242
  • Fax: 800-658-4178
Mailing address:
  • Phone: 505-658-4242
  • Fax: 800-658-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. MONICA CLOSNER-KOZLOWSKI
Title or Position: CFNP
Credential: CFNP
Phone: 505-553-8902