Individual
CARMELA C MONDRAGON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5901 HARPER DRIVE NE, PMG URGENT CARE, ALBUQUERQUE, NM 87109
(505) 823-8519
(505) 823-8355
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP00414
NM
363LF0000X
Family Nurse Practitioner
CNP00414
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74171
—
NM
Enumeration date
12/07/2005
Last updated
10/23/2017
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