Provider Demographics
NPI:1700330560
Name:CORTES MENDEZ, MARISSA D (CNM, CNP)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:D
Last Name:CORTES MENDEZ
Suffix:
Gender:F
Credentials:CNM, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 WYOMING BLVD NE # M40498
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1946
Mailing Address - Country:US
Mailing Address - Phone:505-226-0011
Mailing Address - Fax:
Practice Address - Street 1:8100 WYOMING BLVD NE # M40498
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1946
Practice Address - Country:US
Practice Address - Phone:505-226-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03001363LF0000X
NM709367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife