Basic Information
Provider Information
NPI: 1578124244
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CAREY
FirstName: CHRISTINA
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
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Mailing Information
Address1: 4101 INDIAN SCHOOL RD NE STE 110
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871103991
CountryCode: US
TelephoneNumber: 5057277833
FaxNumber:  
Practice Location
Address1: 4801 MCMAHON BLVD NW STE 245
Address2:  
City: ALBUQUERQUE
State: NM
PostalCode: 871145478
CountryCode: US
TelephoneNumber: 5057277833
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/24/2019
LastUpdateDate: 09/12/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/12/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X66105NMY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363LA2100XAPRN.CNP.024951OHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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