KONTASHA SHAMIKA WISE (NPI# 1679850044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679850044 |
| Entity Type | Individual |
| Full Name | KONTASHA SHAMIKA WISE |
| Credential | ARNP |
| Practice Address |
1051 Carnival Ave Nw Los Lunas NM 87031-7487 |
| Practice Telephone | 8643719811 |
| Mailing Telephone | 8643719811 |
| Enumeration Date | 2011-11-12 |
| Last Update Date | 2016-03-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 17616 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
CNP-02817 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | NP1988 | 05 |
| Street Address |
1051 CARNIVAL AVE NW |
| City | LOS LUNAS |
| State | NM |
| Zip Code | 87031-7487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466212 | Juanita Arcelia Flores-hull | Registered Nurse | 19670 Highway 314, Belen, NM 87031 | 2020-08-06 |
| 1184267171 | Nicole Andrea Bassett | Registered Nurse | 236 Don Pasqual Rd, Los Lunas, NM 87031 | 2019-10-22 |
| 1922649359 | Darrel Thompson | Physical Therapist | 2211 Main St, Ne, Los Lunas, NM 87031 | 2019-10-07 |
| 1407415235 | Brittany Leigh Dow | Family Medicine | 328 Main St Sw, Los Lunas, NM 87031 | 2019-06-05 |
| 1942764162 | Christine Beevers | Occupational Therapy Assistant | 310 Bonita Vista Blvd, Los Lunas, NM 87031 | 2019-01-23 |
| 1669953105 | Patricia A Ziehl | Occupational Therapy Assistant | 119 Luna Ave., Los Lunas, NM 87031 | 2018-08-23 |
| 1922500776 | Mellisa Marie Everett | Massage Therapist | 3414 Nm- 47, Los Lunas, NM 87031 | 2018-03-07 |
| 1831699917 | Nachelle Lynn Pell | Registered Nurse | 310 Bonita Vista, Los Lunas, NM 87031 | 2018-02-15 |
| 1053829135 | Valencia Denise Jackson | Registered Nurse | 46 Chacon Rd., Los Lunas, NM 87031 | 2018-01-11 |
| 1548777972 | Aja Santana Armijo | Speech-Language Pathologist | 46 Chacon Blvd., Los Lunas, NM 87031 | 2018-01-08 |
| Find all providers in zip 87031 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205860566 | Julianne Marie Stangel | Nurse Practitioner | 1375 Vista Hill Ct Sw, Los Lunas, NM 87031-8705 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619323284 | Amy Elise Lopez | Nurse Practitioner | 4402 Superstition Dr, Las Cruces, NM 88011 | 2016-05-12 |
| 1841662095 | Barbara Lynn Edmunds-kimrey | Nurse Practitioner | 8801 Horizon Blvd., Suite 260, United Health Care- Optum, Albuquerque, NM 87109 | 2015-10-28 |
| 1518341759 | Karen Elizabeth Kirst-millspaugh | Nurse Practitioner | 209 E. Allen Ayers Rd., Estancia, NM 87016 | 2015-07-17 |
| 1336542992 | Fusion Health & Wellness | Nurse Practitioner | 2402 W Pierce St Ste 6g, Ste 6g, Carlsbad, NM 88220-3566 | 2014-09-26 |
| 1609129691 | Wayne Bryan Chowaniec | Nurse Practitioner | Unm Cancer Center Msc07 4025 1201 Camino De, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2012-10-16 |
| 1972853349 | Carla Rae Kychik | Nurse Practitioner | 163 Brannon, Tijeras, NM 87059 | 2012-09-13 |
| 1912208323 | Lisa Marie Meyer | Nurse Practitioner | 2539 Medical Drive, Suite 107, Gerald Champion Regional Medical Center, Alamogordo, NM 88310 | 2010-11-16 |
| 1568777530 | Jacqueline Del Val | Nurse Practitioner | 622 W Maple St Ste F, Farmington, NM 87401-6589 | 2010-08-13 |
| 1548439060 | Lynn Engler | Nurse Practitioner | Msc10 5550 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2008-02-28 |
| 1720269178 | Jodi A. Dettman | Nurse Practitioner | 104 Quail Trl Unit B, Edgewood, NM 87015-7185 | 2007-11-14 |
| Find all providers with the same taxonomy | ||||
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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.