Shawn Blaisdell, CFNP, CNM

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R37437 Issued in NM

Practice address

1001 Medical Arts Ave NE
Albuquerque, NM 87102-2708

Phone

(505) 272-0457

Fax

(505) 272-2043

NPI assigned

Jul 11, 2006

Last updated

May 23, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1083649065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MEDICAL ARTS AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022708",
            "telephone_number": "505-272-0457",
            "fax_number": "505-272-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "SHAWN",
        "name_prefix": "Ms.",
        "credential": "CFNP, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R37437",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NM",
            "license": "425",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17605717",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Jane Blair, NP
• Randy Lynn Blair, D.C.
• Traci Gae Blair, R.N,.
• Traci Lee Blair, P.T.
• Travis Anton Blair
• Kathleen Blake, MD
• Cloyce Elizabeth Blakely, PA-C
• F Adele Blakely, MD
• Robert Anthony Blakely, MD
• Katharine Anne Blaker, M.S., CCC-SLP

• Family Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.