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General NPI Number Information
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NPI Number | 1184589368
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Entity Type | Individual
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Provider Name | MRS. DESIRE M MENCHACA
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Gender | Female
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 8650 ALAMEDA BLVD NE STE 101E
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-3791
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Country | US
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Telephone | 505-255-1866
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Fax |
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Provider Business Mailing Address
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Address Line | 9223 BEAVER CREEK RD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-6276
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Country | US
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Telephone | 505-660-2833
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 87224
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License Number State | NM
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