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General NPI Number Information
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NPI Number | 1326595851
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Entity Type | Individual
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Provider Name | NICOLE STIVERS CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1720 LOUISIANA BLVD NE STE 401
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7020
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Country | US
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Telephone | 505-260-4300
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Fax | 505-260-4371
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Provider Business Mailing Address
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Address Line | 1720 LOUISIANA BLVD NE STE 401
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7020
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Country | US
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Telephone | 505-260-4300
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Fax | 505-260-4371
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN0000197254
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 082456-23
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA-01450
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 2022035701
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License Number State | MO
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