Healthcare Provider Details

I. General information

NPI: 1255348207
Provider Name (Legal Business Name): JAMES STAPLETON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 CENTRO FAMILIAR BLVD SW
ALBUQUERQUE NM
87105-4592
US

IV. Provider business mailing address

1231 CANDELARIA RD NW MSC09 5040
ALBUQUERQUE NM
87107-2767
US

V. Phone/Fax

Practice location:
  • Phone: 505-873-7400
  • Fax:
Mailing address:
  • Phone: 505-272-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberR24834
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: