MS. PROVIDENCE MUSOMANDERA BOTNE (NPI# 1326029240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326029240 |
| Entity Type | Individual |
| Full Name | MS. PROVIDENCE MUSOMANDERA BOTNE |
| Credential | R.N. |
| Practice Address |
2600 Marble Albuquerque NM 87151-0001 |
| Mailing Address |
10712 Central Park Dr Ne Albuquerque NM 87123-4849 |
| Practice Telephone | 5058398839 |
| Practice Fax Number | 5058398989 |
| Mailing Telephone | 5052924144 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
R53622 | NM | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | R.N.LICENCE | R53622 | 01 |
| Street Address |
2600 MARBLE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87151-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447249644 | Kenneth Wayne Lovelett Jr. | Counselor | 2600 Marble, Albuquerque, NM 87151-0001 | 2005-10-19 |
| 1700947199 | Dawn M Halperin | Counselor | 2600 Marble, Albuquerque, NM 87131-5547 | 2006-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194388496 | Anne E. Galanis | Nurse Practitioner | 100 Deputy Dean Miera Dr Sw: Bernalillo County Metropol, Albuquerque, NM 87151 | 2019-04-22 |
| 1780663534 | Robert Otto Krammer | Registered Nurse | 500 Shelly Rd., Albuquerque, NM 87151-0001 | 2006-01-11 |
| 1356332852 | Walter Kerry Viers | Registered Nurse | 500 Shelly Rd. S.w., Albuquerque, NM 87151-0001 | 2005-11-03 |
| 1336120245 | Marian Margaret Mesojedic | Registered Nurse | 2600 Marble Ne, Albuquerque, NM 87151-0001 | 2005-11-08 |
| 1194023671 | Michelle Renee Lucero | Physician Assistant | 100 Deputy Dean Miera Dr Sw, Albuquerque, NM 87151-0100 | 2011-03-07 |
| 1629387261 | William Michael Shannon | Family Medicine | 100 John Dantis Dr, Albuquerque, NM 87151-0100 | 2010-09-30 |
| 1538140330 | Andrea Yvonne Sutphin | Registered Nurse | 100 John Dantis Rd Sw, Albuquerque, NM 87151-0100 | 2005-11-09 |
| 1275843781 | Jon-paul Hamilton | Psychiatry & Neurology | 100 John Dantis Rd Sw, Albuquerque, NM 87151-0100 | 2010-10-18 |
| 1154637767 | Correctional Healthcare Companies | Dentist | 100 John Dantis Rd Sw, Albuquerque, NM 87151-0100 | 2010-08-20 |
| 1467779546 | Timothy Ivan Mcmurray | Internal Medicine | 100 John Dantis Rd Sw, Albuquerque, NM 87151-0100 | 2010-04-28 |
| Find all providers in zip 87151 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366086365 | Laura Hoopes | Registered Nurse | 2600 Marble Ave Ne Fl 2, Albuquerque, NM 87106-2058 | 2019-11-01 |
| 1245463702 | Asha Dvora Pollem | Registered Nurse | 2661 Floral Rd Nw, Albuquerque, NM 87104-1956 | 2009-09-01 |
| 1568621324 | Anne T Stats | Registered Nurse | 2600 Marble, Rrp Clinic, Mental Health Center, Unmh, Albuquerque, NM 87131-5426 | 2008-06-06 |
| 1659429207 | Razvan N Preda | Registered Nurse | 2600 Marble Ave. Ne, Msc10 5640, Albuquerque, NM 87131-5426 | 2007-01-08 |
| 1720144595 | Leslie Kern | Registered Nurse | 800 Alvarado Dr Ne, Albuquerque, NM 87108-1649 | 2006-12-28 |
| 1932272101 | Deborah Ann Holmes | Registered Nurse | 1501 San Pedro Dr Se # 116, Albuquerque, NM 87108-5153 | 2006-11-16 |
| 1780663534 | Robert Otto Krammer | Registered Nurse | 500 Shelly Rd., Albuquerque, NM 87151-0001 | 2006-01-11 |
| 1538140330 | Andrea Yvonne Sutphin | Registered Nurse | 100 John Dantis Rd Sw, Albuquerque, NM 87151-0100 | 2005-11-09 |
| 1922623990 | Valerie Bustos | Registered Nurse | 2600 Marble Ave Ne, Albuquerque, NM 87106-2058 | 2020-06-15 |
| 1427686542 | Alexis Norberto Graf | Registered Nurse | 1501 San Pedro Dr Se, Albuquerque, NM 87108-5180 | 2020-04-01 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87151 |
Please comment or provide details below to improve the information on MS. PROVIDENCE MUSOMANDERA BOTNE.
| 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.