Provider Demographics
NPI:1396336392
Name:EL-YASSIN, HIBA (MSN, APRN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:HIBA
Middle Name:
Last Name:EL-YASSIN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 MAXINE ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1206
Mailing Address - Country:US
Mailing Address - Phone:505-610-0550
Mailing Address - Fax:
Practice Address - Street 1:6349 US HIGHWAY 550 CUBA, NM 87103
Practice Address - Street 2:
Practice Address - City:CUBA
Practice Address - State:NM
Practice Address - Zip Code:87103
Practice Address - Country:US
Practice Address - Phone:505-610-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-01
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10002780363LF0000X
NM62690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily