Healthcare Provider Details

I. General information

NPI: 1689468753
Provider Name (Legal Business Name): KUNAL DHARMENDRA HEMNANI CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2025
Last Update Date: 07/08/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE NM
87102-3619
US

IV. Provider business mailing address

6709 ACADEMY RD NE STE A
ALBUQUERQUE NM
87109-3363
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-8000
  • Fax:
Mailing address:
  • Phone: 240-708-0033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number84385
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: