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General NPI Number Information
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NPI Number | 1154868420
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Entity Type | Individual
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Provider Name | EVERARDO GARCIA MSN, APRN, PMHNP
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Gender | Male
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 4801 LANG AVE NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4475
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Country | US
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Telephone | 505-393-7493
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Fax | 330-578-7877
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Provider Business Mailing Address
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Address Line | 4801 LANG AVE NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4475
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Country | US
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Telephone | 505-551-1994
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95008494
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95022888
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License Number State | CA
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