MEDICARE: MR. JONATHAN ASA CADE RN, MSN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	COA03615	OH
2	363LF0000X	Family Nurse Practitioner	CNP01942	NM
3	163W00000X	Registered Nurse	RN259257	OH

General Provider Information

NPI Number	:	1013155258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JONATHAN ASA CADE RN, MSN, FNP-C

Provider Business Mailing Address
First Line	:	3825 EUBANK BLVD NE
Second Line	:	STE A
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3559
Country	:	US
Telephone Number	:	505-292-8575
Fax Number	:	505-292-8409

Provider Business Practice Location Address
First Line	:	3825 EUBANK BLVD NE
Second Line	:	STE A
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3559
Country	:	US
Telephone Number	:	505-292-8575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	06/21/2019

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