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General NPI Number Information
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NPI Number | 1518284546
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Entity Type | Individual
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Provider Name | JANE MAE IVES PMHNP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2010
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Last Update Date | 06/01/2025
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Provider Practice Location Address
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Address Line | 102 GOLD AVE SW # 548
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-3335
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Country | US
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Telephone | 702-589-4871
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6835
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City | ALBUQUERQUE
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State | NM
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Zip | 87197-6835
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Country | US
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Telephone | 225-305-4200
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 777942
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP07102
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP78297
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License Number State | NM
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