Active NPI
Laura Kris McCleskey, CNP
- Family Nurse Practitioner
- Rio Rancho, NM
National Provider Identifier
1043734411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- CNP-03323
- Practice address
- 3751 Southern Blvd NE
Suite a
Rio Rancho, NM 87124 - Phone
- (505) 306-2293
- NPI assigned
- Jul 27, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CNP-03323 | NM | |
| Family Nurse Practitioner | 363LF0000X | CNP-03323 | NM | Primary |
Addresses
Primary practice location
3751 Southern Blvd NE
Suite a
Rio Rancho, NM 87124
Mailing address
3751 Southern Blvd NE
Suite a
Rio Rancho, NM 87124-4291
Phone (505) 306-2293
Other practice location 1
3901 Carlisle Blvd NE
Albuquerque, NM 87107-4503
Phone (505) 888-8500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CNP-03323 | Other | NM | NEW MEXICO BOARD OF NURSING CNP LICENSE NUMBER |
Other names 1
- Mrs. Laura Kris Dudley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP-03323 | NM | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1043734411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3751 SOUTHERN BLVD NE",
"address_2": "SUITE A",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871244291",
"telephone_number": "505-306-2293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3751 SOUTHERN BLVD NE",
"address_2": "SUITE A",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "87124",
"telephone_number": "505-306-2293"
}
],
"practiceLocations": [
{
"address_1": "3901 Carlisle Blvd NE",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "871074503",
"country_code": "US",
"telephone_number": "505-888-8500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCLESKEY",
"first_name": "LAURA",
"middle_name": "KRIS",
"name_prefix": "Mrs.",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-27",
"last_updated": "2021-05-24",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NM",
"license": "CNP-03323",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NM",
"license": "CNP-03323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO BOARD OF NURSING CNP LICENSE NUMBER",
"identifier": "CNP-03323",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "DUDLEY",
"middle_name": "KRIS",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.