Provider Demographics
NPI:1801821038
Name:CLAPP, NADINE A (MD)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:A
Last Name:CLAPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 MONTGOMERY BLVD NE
Mailing Address - Street 2:STE 201
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1233
Mailing Address - Country:US
Mailing Address - Phone:505-217-1844
Mailing Address - Fax:404-601-6722
Practice Address - Street 1:5901J WYOMING BLVD NE # 163
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3866
Practice Address - Country:US
Practice Address - Phone:505-217-1844
Practice Address - Fax:404-601-6722
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-12-08
Deactivation Date:2020-01-22
Deactivation Code:
Reactivation Date:2020-12-08
Provider Licenses
StateLicense IDTaxonomies
NMNM9228207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM160050082OtherRAILROAD RETIREMENT PROV
NM201001798OtherPRES HEALTH PLAN PROV #
NMF6995Medicaid
NMNM002285OtherBCBS PROV NUMBER
NMNM002285OtherBCBS PROV NUMBER
NMC97357Medicare UPIN
NMF6995Medicaid
NM343523500Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER