Individual provider Active NPI

Nola L Maez

  • Registered Nurse
  • Albuquerque, NM
National Provider Identifier
1568629012
Registry record updated May 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R58530 Issued in NM
Practice address
4208 Packaway Rd NW
Albuquerque, NM 87114-5631
Phone
(505) 440-6965
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R58530 NM Primary

Addresses

Primary practice location

4208 Packaway Rd NW
Albuquerque, NM 87114-5631

Mailing address

4208 Packaway Rd NW
Albuquerque, NM 87114-5631
Phone (505) 440-6965

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

State licenses

LicenseStateTypeSpecialty
R58530NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1568629012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 PACKAWAY RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145631",
            "telephone_number": "505-440-6965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 PACKAWAY RD NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145631",
            "telephone_number": "505-440-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAEZ",
        "first_name": "NOLA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R58530",
            "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 May 21, 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.