Healthcare Provider Details

I. General information

NPI: 1497282909
Provider Name (Legal Business Name): JAVED CAPRIETTA ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2017
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

IV. Provider business mailing address

425 TOWN PLAZA AVE
PONTE VEDRA FL
32081-5164
US

V. Phone/Fax

Practice location:
  • Phone: 505-393-4960
  • Fax:
Mailing address:
  • Phone: 888-307-9875
  • Fax: 505-369-7596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-03316
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9340971
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN9340971
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP03316
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: