Healthcare Provider Details
I. General information
NPI: 1164702809
Provider Name (Legal Business Name): FRANCIS Q. CORTES PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/25/2011
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 MADEIRA DR NE SUITE 222
ALBUQUERQUE NM
87108-1522
US
IV. Provider business mailing address
120 MADEIRA DR NE SUITE 222
ALBUQUERQUE NM
87108-1522
US
V. Phone/Fax
- Phone: 505-359-7220
- Fax:
- Phone: 505-359-7220
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | CNP-01825 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: