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Organization
MIND AND BODY MEDICAL AND RECOVERY
Active
Organization
MIND AND BODY MEDICAL AND RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MESTAS PMHNP-BC (PSYCHIATRIC MENTAL HEALTH NP)
(505) 999-0470
Entity
Organization
Contact information
Practice address
2900 LOUISIANA BLVD NE STE A2, ALBUQUERQUE, NM 87110-3550
(505) 999-0470
Mailing address
2900 LOUISIANA BLVD NE STE A2, ALBUQUERQUE, NM 87110-3550
(505) 999-0470
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/01/2025
Last updated
04/01/2025
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