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NPI Code Detail

MEDICARE: NICHOLE ALIRE CPSW

MEDICARE: NICHOLE ALIRE CPSW
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
1171M00000XCase Manager/Care Coordinator
2175T00000XPeer Specialist1573NM

General Provider Information

NPI Number : 1790462919
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLE ALIRE CPSW
Provider Business Mailing Address
First Line : 4010 CARLISLE BLVD NE STE F
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87107-4532
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5601 DOMINGO RD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-1610
Country : US
Telephone Number : 52-685-2955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2023
Last Update Date : 06/03/2026

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Directions to “ NICHOLE ALIRE CPSW” Practice Location

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