Individual provider Active NPI

Jeanne Monske, C.P.N.P.

  • Pediatric Nurse Practitioner
  • Ruidoso, NM
National Provider Identifier
1245339951
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R24569 Issued in NM
Practice address
1401 Sudderth Dr
Ruidoso, NM 88345-6104
Phone
(575) 257-7712
Fax
(575) 257-4513
NPI assigned
Sep 21, 2006
Last updated
Apr 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X R24569 NM Primary

Addresses

Primary practice location

1401 Sudderth Dr
Ruidoso, NM 88345-6104

Mailing address

30 Adobe Ranch TRL
Alamogordo, NM 88310-4193
Phone (505) 437-2665

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 Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R24569NMMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Clinic Corp Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1245339951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ADOBE RANCH TRL",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883104193",
            "telephone_number": "505-437-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456104",
            "telephone_number": "575-257-7712",
            "fax_number": "575-257-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONSKE",
        "first_name": "JEANNE",
        "credential": "C.P.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "R24569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.