Provider Demographics
NPI:1407176597
Name:MONTANO, KRISTEL NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEL
Middle Name:NICOLE
Last Name:MONTANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTEL
Other - Middle Name:NICOLE
Other - Last Name:TAFOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:MSC10 5590
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-5551
Practice Address - Fax:505-272-6845
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT197376208000000X
NMMD20130456208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics