Basic Information
Provider Information
NPI: 1073640066
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NUNEZ
FirstName: KAREN
MiddleName: E.
NamePrefix: MS.
NameSuffix:  
Credential: CNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2600 YALE BLVD SE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871064217
CountryCode: US
TelephoneNumber: 5059947954
FaxNumber: 5052430366
Practice Location
Address1: 2600 YALE BLVD SE
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871064217
CountryCode: US
TelephoneNumber: 5059947954
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 08/17/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XR57184NMY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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