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KONTASHA SHAMIKA WISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
8226 MENAUL BLVD NE # 144, ALBUQUERQUE, NM 87110-4614
(505) 544-2366
Mailing address
8226 MENAUL BLVD NE # 144, ALBUQUERQUE, NM 87110-4614
(505) 544-2366

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
17616
SC
363LA2200X
Adult Health Nurse Practitioner
CNP02817
NM
363LF0000X
Family Nurse Practitioner
CNP02817
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP02817
NM
363LP2300X
Primary Care Nurse Practitioner
CNP02817
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6929753
NM
Enumeration date
11/12/2011
Last updated
09/05/2025
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