Provider Demographics
NPI:1023346350
Name:NEW MEXICO NURSE, LLC.
Entity type:Organization
Organization Name:NEW MEXICO NURSE, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-508-1881
Mailing Address - Street 1:5010 CUTLER AVE NE
Mailing Address - Street 2:STE. D2-180
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4084
Mailing Address - Country:US
Mailing Address - Phone:505-508-1881
Mailing Address - Fax:505-508-1909
Practice Address - Street 1:3939 SAN PEDRO DR NE
Practice Address - Street 2:BLDG. C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-8900
Practice Address - Country:US
Practice Address - Phone:505-508-1881
Practice Address - Fax:505-508-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMFA0066866251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care