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General NPI Number Information
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NPI Number | 1750997391
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Entity Type | Individual
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Provider Name | CRYSTAL OTERO-GRIFFITH CNP
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Gender | Female
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 1216 5TH ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87102-1312
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Country | US
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Telephone | 505-417-1413
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Fax |
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Provider Business Mailing Address
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Address Line | 8227 CALLE PRIMERA NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-5392
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Country | US
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Telephone | 505-417-1413
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 61521
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 61521
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License Number State | NM
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