Provider Demographics
NPI:1912282344
Name:ORTEGA, MONICA E (CNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:E
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5909 ALICE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6501
Mailing Address - Country:US
Mailing Address - Phone:505-200-2647
Mailing Address - Fax:505-200-2695
Practice Address - Street 1:7007 JEFFERSON ST NE STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4450
Practice Address - Country:US
Practice Address - Phone:505-340-0406
Practice Address - Fax:505-340-0405
Is Sole Proprietor?:No
Enumeration Date:2011-10-17
Last Update Date:2020-03-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMCNP 01860363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM43735258Medicaid
NM43735258Medicaid