Healthcare Provider Details

I. General information

NPI: 1629937339
Provider Name (Legal Business Name): VITAL EXPLORATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 01/19/2026
Certification Date: 01/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 CANDELARIA RD NE STE A
ALBUQUERQUE NM
87107-1952
US

IV. Provider business mailing address

10505 COYOTE CANYON PL NW
ALBUQUERQUE NM
87114-5949
US

V. Phone/Fax

Practice location:
  • Phone: 505-999-1488
  • Fax:
Mailing address:
  • Phone: 505-999-1488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CAMERON PELLEGRINO
Title or Position: OWNER
Credential: PMHNP
Phone: 505-999-1488