Cynthia M. Montanez, RN
Individual provider Active NPI Registered Nurse · Dulce, NM
NPI 1467778365 · NPPES record last updated Apr 16, 2010
Key facts
- NPI
- 1467778365
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 147647 (AZ)
- Practice address
- 12000 Stone Lake Road
Jicarilla Service Unit
Dulce, NM 87528 - Phone
- (575) 759-3291
- Fax
- (575) 759-7294
- NPI assigned
- Apr 16, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147647 | AZ | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DHHS/IHS/Aao/Jsu/Dulce Health Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 147647 | AZ | Yes |
Addresses
Primary practice location
12000 Stone Lake Road
Jicarilla Service Unit
Dulce, NM 87528
Mailing address
12000 Stone Lake Road
Jicarilla Service Unit
Dulce, NM 87528
Phone (575) 759-3291
Other providers in Dulce, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.