Provider Demographics
NPI:1649561986
Name:UNIVERSITY OF NEW MEXICO
Entity Type:Organization
Organization Name:UNIVERSITY OF NEW MEXICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:CLAIRE
Authorized Official - Last Name:HOLGUIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:814-450-3088
Mailing Address - Street 1:9800 BAJADA DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4365
Mailing Address - Country:US
Mailing Address - Phone:505-272-5595
Mailing Address - Fax:505-272-6091
Practice Address - Street 1:9800 BAJADA DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4365
Practice Address - Country:US
Practice Address - Phone:505-272-5595
Practice Address - Fax:505-272-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital