Carolyn Diane P. Mourad, RN

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

R26250 Issued in NM

Practice address

1976 Corta Rustica Rd
Los Lunas, NM 87031-7507

Phone

(505) 865-9842

NPI assigned

Jul 17, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1427288968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1976 CORTA RUSTICA RD",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317507",
            "telephone_number": "505-865-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1976 CORTA RUSTICA RD",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317507",
            "telephone_number": "505-865-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOURAD",
        "first_name": "CAROLYN",
        "middle_name": "DIANE P.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-17",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "NM",
            "license": "R26250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE, NEW MEXICO LICENSE",
            "identifier": "R26250",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "R26250",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Care Registered Nurse in Los Lunas, NM
• Providers in Los Lunas, NM by specialty
• Ambulatory Care Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.