Healthcare Provider Details

I. General information

NPI: 1144513151
Provider Name (Legal Business Name): KYEREWAA ABBAN-THOMPSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2011
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 ACADEMY RD NE STE 104
ALBUQUERQUE NM
87109-3379
US

IV. Provider business mailing address

7801 ACADEMY RD NE STE 104
ALBUQUERQUE NM
87109-3379
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7000
  • Fax:
Mailing address:
  • Phone: 505-730-5020
  • Fax: 505-212-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number70195
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: