MISS LISA K BUSHNELL (NPI# 1174524912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174524912 |
Entity Type | Individual |
Full Name | MISS LISA K BUSHNELL |
Credential | C.F.N.P. |
Practice Address |
1393 Weimer Rd Taos NM 87571-6253 |
Practice Telephone | 5757588651 |
Practice Fax Number | 5757587811 |
Mailing Telephone | 5757588651 |
Mailing Fax Number | 5757587811 |
Enumeration Date | 2005-08-02 |
Last Update Date | 2011-08-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207K00000X | Allergy & Immunology | R54485 | NM | Allopathic & Osteopathic Physicians |
Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
R54485 | NM | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 5670349 | 05 | |
NM | 00051474 | 05 | |
NM | BLUE MEDICARE | 00NM006H13 | 01 |
CIGNA / LOVELACE | 10021342 | 01 | |
AETNA | 7722751 | 01 | |
MOLINA | QMP000003404562 | 01 | |
BLUE CROSS & BLUE SHIELD | NM006H13 | 01 | |
PRESBYTERIAN | 202024643 | 01 |
Street Address |
1393 WEIMER RD |
City | TAOS |
State | NM |
Zip Code | 87571-6253 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518962190 | Debra Beth Singer | Pediatrics | 1393 Weimer Rd, Taos, NM 87571-6253 | 2005-06-20 |
1295285278 | Bridget Shea-gander | Nurse Practitioner | 1393 Weimer Rd, 1393 Weimer Rd, Taos, NM 87571-6253 | 2016-10-13 |
1396037396 | Sarah Terry Drenning | Nurse Practitioner | 1393 Weimer Rd, Taos, NM 87571-6253 | 2011-05-09 |
1154350205 | Taos Clinic for Children and Youth | Pediatrics | 1393 Weimer Rd, Taos, NM 87571-6253 | 2006-07-01 |
1740248756 | Sylvia Fernandez Villarreal | Pediatrics | 1393 Weimer Rd, Taos, NM 87571-6253 | 2006-05-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174080923 | Veronika Anne Peacetree | Counselor | Vds-taos, 314 Don Fernando Street, Taos, NM 87571 | 2019-02-28 |
1043785603 | Lindsey M Schreiber | Counselor | 412 Sipapu Street, Taos, NM 87571 | 2018-10-10 |
1881173698 | Mia M Mcmullen | Specialist/Technologist | Enos Garcia Elementary School, 305 Don Fernando St, Taos, NM 87571 | 2018-08-13 |
1992225403 | Ted Dimond | Counselor | 525 Salazar Rd, Suite A, Taos, NM 87571 | 2017-06-26 |
1467908103 | Jacqueline Danielle Arcand | Social Worker | 250 Shadow Mountain Rd, Taos, NM 87571 | 2016-09-01 |
1225487812 | James Lucero | Social Worker | 905 Witt Rd., Taos, NM 87571 | 2016-06-06 |
1083098370 | Ellen Durant | Marriage & Family Therapist | 1135 Butterfly Rd, Taos, NM 87571 | 2015-07-16 |
1831584192 | Eight Northern Indian Pueblos Council, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1130 Butterfly Rd., Taos, NM 87571 | 2015-04-03 |
1790179844 | Eight Northern Indian Pueblos | Substance Abuse Rehabilitation Facility | 1130 Butterfly Road, Taos, NM 87571 | 2015-03-26 |
1992106041 | Debbie I Salazar, Lisw Ltd Co | Community/Behavioral Health | 208 Ranchitos Road Unit B, Taos, NM 87571 | 2014-09-09 |
Find all providers in zip 87571 |
Taxonomy Code | 364SP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063871176 | Eugene Ray Snyder | Clinical Nurse Specialist | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2016-02-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.