Individual provider Active NPI

Cynthia Louise Nielsen, MSN ANP-BC

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1104248392
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP-02321 Issued in NM
Practice address
8208 Louisiana Blvd NE
Suite C
Albuquerque, NM 87113-1757
Phone
(505) 858-1222
Fax
(505) 858-1224
NPI assigned
Jan 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CNP-02321 NM Primary
Nurse Practitioner 363L00000X R19639 NM

Addresses

Primary practice location

8208 Louisiana Blvd NE
Suite C
Albuquerque, NM 87113-1757

Mailing address

8208 Louisiana Blvd NE
Suite C
Albuquerque, NM 87113-1757
Phone (505) 858-1222

Other identifiers 1

IdentifierTypeStateIssuer
48838543MedicaidNM

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
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP-02321NMMDNurse Practitioner
R19639NMMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1389139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463702400000",
    "number": "1104248392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8208 LOUISIANA BLVD NE",
            "address_2": "SUITE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131757",
            "telephone_number": "505-858-1222",
            "fax_number": "505-858-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8208 LOUISIANA BLVD NE",
            "address_2": "SUITE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131757",
            "telephone_number": "505-858-1222",
            "fax_number": "505-858-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "CYNTHIA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "MSN ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-08",
        "last_updated": "2016-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-02321",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R19639",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48838543",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.