Active NPI
Amanda Fraser, L.M.T.,R.N.
- Psychiatric/Mental Health Registered Nurse
- Albuquerque, NM
National Provider Identifier
1295934818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- RN70412
- Practice address
- 2600 Marble Ave NE
Albuquerque, NM 87106-2058 - Phone
- (505) 272-1977
- NPI assigned
- Jul 13, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 4045 | NM | |
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | RN70412 | NM | Primary |
Addresses
Primary practice location
2600 Marble Ave NE
Albuquerque, NM 87106-2058
Mailing address
4997 Butte PL NW
Albuquerque, NM 87120-4410
Phone (505) 999-6243
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)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN70412 | NM | MD | Psychiatric/Mental Health Registered Nurse |
| 4045 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456444800000",
"number": "1295934818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4997 BUTTE PL NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871204410",
"telephone_number": "505-999-6243"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 MARBLE AVE NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871062058",
"telephone_number": "505-272-1977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER",
"first_name": "AMANDA",
"credential": "L.M.T.,R.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-13",
"last_updated": "2016-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "4045",
"primary": false
},
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "NM",
"license": "RN70412",
"primary": true
}
],
"identifiers": [],
"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 Feb 26, 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.