Myrna M Gallegos, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R18208 Issued in NM

Practice address

2929 Coors Blvd NW
Suite 200
Albuquerque, NM 87120-1173

Phone

(505) 839-2328

Fax

(505) 839-2303

NPI assigned

Jul 26, 2006

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

Other names 1

• Myrna M. Gallegos Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Optumcare Endoscopy Center New Mexico, LLC

  • Ambulatory Surgical Clinic/Center
  • Albuquerque, NM
  • NPI 1962685834
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1194748202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26028",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256028",
            "telephone_number": "505-839-2300",
            "fax_number": "505-839-2303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 COORS BLVD NW",
            "address_2": "SUITE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201173",
            "telephone_number": "505-839-2328",
            "fax_number": "505-839-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLEGOS",
        "first_name": "MYRNA",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00260",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R18208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H4698",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRNA",
            "last_name": "GALLEGOS",
            "middle_name": "M.",
            "credential": "CNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Melody D Gallegos, OT
• Michaela Gallegos, PHARMD
• Michelle Gallegos, C-PNP
• Michelle Gallegos
• Miguel Lorenzo Gallegos, M.D.
• Nicole Gallegos
• Nikki K Gallegos
• Oyahan C Gallegos, RN
• Paola Ruth Gallegos
• Patricio Gallegos

• 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 Sep 17, 2019; 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.