Healthcare Provider Details

I. General information

NPI: 1144041781
Provider Name (Legal Business Name): CIARA MUSSER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MARBLE AVE NE
ALBUQUERQUE NM
87106-2058
US

IV. Provider business mailing address

1117 MONROE ST SE
ALBUQUERQUE NM
87108-4517
US

V. Phone/Fax

Practice location:
  • Phone: 717-309-0867
  • Fax:
Mailing address:
  • Phone: 717-309-0867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number80879
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: