Individual
MRS. JULIEANNE M. NIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
8401 CONSTITUTION AVE NE, SUITE 150, ALBUQUERQUE, NM 87110-7604
(505) 727-3800
(505) 727-3808
Mailing address
8401 CONSTITUTION AVE NE, SUITE 150, ALBUQUERQUE, NM 87110-7604
(505) 727-3800
(505) 727-3808
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
R26903
NM
363LF0000X
Family Nurse Practitioner
Primary
CNP00509
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23977060
—
NM
01
—
326368YR41
MEDICARE PTAN
NM
01
—
R26903
STATE LICENSE NUMBER
NM
Enumeration date
08/05/2006
Last updated
09/22/2015
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