Healthcare Provider Details

I. General information

NPI: 1497997613
Provider Name (Legal Business Name): CLARINDA NUNEZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2009
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 STANFORD DR NE
ALBUQUERQUE NM
87106-3721
US

IV. Provider business mailing address

1111 STANFORD DR NE
ALBUQUERQUE NM
87106-3721
US

V. Phone/Fax

Practice location:
  • Phone: 505-841-4100
  • Fax:
Mailing address:
  • Phone: 505-841-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberR18393
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: