MEDICARE: ABIGAIL WOLAVER RN, MSN, NP-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	363L00000X	Nurse Practitioner	CNP-01952	NM
2	163WS0200X	School Registered Nurse	R57700	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992077127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL WOLAVER RN, MSN, NP-C

Provider Business Mailing Address
First Line	:	2921 CAMINO DE LOS CABALLOS
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-9494
Country	:	US
Telephone Number	:	505-467-1600
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 CAMINO DE LOS CABALLOS
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-9494
Country	:	US
Telephone Number	:	505-467-1600
Fax Number	:

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

Provider Enumeration Date	:	02/03/2012
Last Update Date	:	02/10/2026

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