Organization
BEEWELL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KONTASHA SHAMIKA WISE (CNP, PMHNP-BC)
(505) 554-8315
Entity
Organization
Contact information
Practice address
4201 CARLISLE BLVD NE # C, ALBUQUERQUE, NM 87107-4808
(505) 544-2366
(505) 581-6988
Mailing address
8226 MENAUL BLVD NE # 144, ALBUQUERQUE, NM 87110-4614
(505) 544-2366
(505) 581-6988
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06929753
—
NM
Enumeration date
12/25/2020
Last updated
07/17/2025
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