Provider Demographics
NPI:1083783781
Name:ADAMES, M. ELISA (APRN-BC)
Entity Type:Individual
Prefix:
First Name:M.
Middle Name:ELISA
Last Name:ADAMES
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 YALE BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4217
Mailing Address - Country:US
Mailing Address - Phone:505-994-7967
Mailing Address - Fax:505-243-0360
Practice Address - Street 1:2600 YALE BLVD SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4217
Practice Address - Country:US
Practice Address - Phone:505-994-7967
Practice Address - Fax:505-243-0360
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR20323363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health