MEDICARE: MISRA MEDICAL LLC

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	363LA2200X	Adult Health Nurse Practitioner

General Provider Information

NPI Number	:	1720930555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISRA MEDICAL LLC

Provider Business Mailing Address
First Line	:	3801 CALLE PINO NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-4342
Country	:	US
Telephone Number	:	505-221-6342
Fax Number	:	505-212-4581

Provider Business Practice Location Address
First Line	:	8232 LOUISIANA BLVD NE STE A
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87113-2429
Country	:	US
Telephone Number	:	505-221-6342
Fax Number	:	505-212-4581

Authorized Official
Title or Position	:	APN/OWNER
Name	:	SHEILA MISRA
Credential	:	APN
Telephone Number	:	505-221-6342

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/14/2026

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Directions to “MISRA MEDICAL LLC ” Practice Location

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