Relindis Mana Akwanga, CNP

Individual provider Active NPI Family Nurse Practitioner · Gallup, NM

NPI 1093332975 · NPPES record last updated Mar 23, 2021

Key facts

NPI
1093332975
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
62749 (NM)
Practice address
610 N Fifth St
Gallup, NM 87301-5306
Phone
(505) 863-3120
Fax
(505) 863-2961
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Presbyterian Medical Services (132 clinicians)

Practice addresses (Care Compare)

1422 Paseo de Peralta
Santa Fe, NM 87501-4391
Phone (505) 982-5565

Hospital & facility affiliations

  • Cibola General Hospital Hospital · Grants, NM · CCN 321308
  • Rehoboth McKinley Christian Health Care Services Hospital · Gallup, NM · CCN 321313

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210427000241 NM Practitioner - Nurse Practitioner 7911315288 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
62749NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Medical Services Current
since May 3, 2021
Accepting new patients
Presbyterian Medical Services Current Accepting new patients
Presbyterian Medical Services Current
since May 3, 2021
Accepting new patients

Locations

610 N Fifth St
Gallup, NM 87301
Phone (505) 863-3120

1055 Rico St
Gallup, NM 87301
Phone (505) 721-2681

1422 Paseo de Peralta
Santa Fe, NM 87501
Phone (505) 982-5565

Interoperability endpoints

  • Direct secure messaging: relindis.akwanga.p1@direct.pmsnm.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 62749 NM Yes

Addresses

Primary practice location

610 N Fifth St
Gallup, NM 87301-5306

Mailing address

610 N Fifth St
Gallup, NM 87301-5306
Phone (505) 863-3120

Other names

  • Relindis Mana Teba Former name

Other providers in Gallup, NM

All providers in Gallup, NM · Family Nurse Practitioner in New Mexico

Sources for this page

Verify at the official NPI Registry.