Provider Demographics
NPI:1558799080
Name:CARDONA, GENEVIEVE RAE (CNP)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:RAE
Last Name:CARDONA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 EUBANK BLVD NE
Mailing Address - Street 2:#A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3575
Mailing Address - Country:US
Mailing Address - Phone:505-292-8575
Mailing Address - Fax:
Practice Address - Street 1:3825 EUBANK BLVD NE
Practice Address - Street 2:#A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3575
Practice Address - Country:US
Practice Address - Phone:505-292-8575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-18
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily