Basic Information
Provider Information | |||||||||
NPI: | 1174562730 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | NURSEFINDERS, LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | NURSEFINDERS OF ALBUQUERQUE | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 524 E LAMAR BLVD | ||||||||
Address2: | SUITE 300 | ||||||||
City: | ARLINGTON | ||||||||
State: | TX | ||||||||
PostalCode: | 760113903 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8174629063 | ||||||||
FaxNumber: | 8174629143 | ||||||||
Practice Location | |||||||||
Address1: | 4411 MCLEOD RD NE | ||||||||
Address2: | SUITE A-1A | ||||||||
City: | ALBUQUERQUE | ||||||||
State: | NM | ||||||||
PostalCode: | 871092227 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5058845041 | ||||||||
FaxNumber: | 5058886415 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/06/2006 | ||||||||
LastUpdateDate: | 02/24/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | JACKSON | ||||||||
AuthorizedOfficialFirstName: | DENISE | ||||||||
AuthorizedOfficialMiddleName: | L | ||||||||
AuthorizedOfficialTitleorPosition: | SENIOR VICE PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 8588920711 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | Y | ||||||||
ParentOrganizationLBN: | AMN HEALTHCARE, INC. | ||||||||
AuthorizedOfficialNamePrefix: | MS. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 6577 | NM | Y |   | Agencies | Home Health |   |
ID Information
ID | Type | State | Issuer | Description | N2912 | 05 | NM |   | MEDICAID |