Healthcare Provider Details

I. General information

NPI: 1992437354
Provider Name (Legal Business Name): CALM PSYCHIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2022
Last Update Date: 10/02/2023
Certification Date: 10/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 RIVERSIDE PLAZA LN NW STE 118
ALBUQUERQUE NM
87120-2617
US

IV. Provider business mailing address

6300 RIVERSIDE PLAZA LN NW STE 118
ALBUQUERQUE NM
87120-2617
US

V. Phone/Fax

Practice location:
  • Phone: 505-507-1132
  • Fax: 855-450-1322
Mailing address:
  • Phone: 505-507-1132
  • Fax: 855-450-1322

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: NNEKA OKOH GODWIN
Title or Position: PMHNP
Credential: NP
Phone: 505-507-1132