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General NPI Number Information
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NPI Number | 1750917928
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Entity Type | Individual
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Provider Name | CAMERON PELLEGRINO PMHNP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2020
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 3311 CANDELARIA RD NE STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-1952
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Country | US
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Telephone | 505-999-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 10505 COYOTE CANYON PL NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5949
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 80999
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License Number State | NM
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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 | 87329
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License Number State | NM
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