Provider Demographics
NPI:1497573422
Name:FAAGAI, EDWARD PILIMOO
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:PILIMOO
Last Name:FAAGAI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:WAKI
Other - Middle Name:
Other - Last Name:FAAGAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:C-FNP
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-823-8888
Mailing Address - Fax:505-823-8238
Practice Address - Street 1:5901 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3587
Practice Address - Country:US
Practice Address - Phone:505-823-8888
Practice Address - Fax:505-823-8238
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM82249363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner