Healthcare Provider Details

I. General information

NPI: 1831915370
Provider Name (Legal Business Name): ABIGAIL YAZZIE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2024
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8725 ALAMEDA PARK DR NE
ALBUQUERQUE NM
87113-2475
US

IV. Provider business mailing address

8725 ALAMEDA PARK DR NE
ALBUQUERQUE NM
87113-2475
US

V. Phone/Fax

Practice location:
  • Phone: 505-828-0232
  • Fax: 833-973-4751
Mailing address:
  • Phone: 505-828-0232
  • Fax: 833-973-4751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number81428
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: