MEDICARE: BAILEY ELIZABETH KIMBEL CNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	65778	NM

General Provider Information

NPI Number	:	1487274932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY ELIZABETH KIMBEL CNP

Provider Business Mailing Address
First Line	:	1 UNIVERSITY OF NEW MEXICO MSC09 5030
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87131-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2155 LOUISIANA BLVD NE STE 1200
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-5495
Country	:	US
Telephone Number	:	505-503-6300
Fax Number	:

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

Provider Enumeration Date	:	04/24/2020
Last Update Date	:	03/06/2026

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