Mustang Management Group TR

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

MUSTANG MANAGEMENT GROUP TR

Practice address

500 Marquette Ave NW Ste 1219
Albuquerque, NM 87102-5340

Phone

(505) 316-5966

Fax

(505) 422-4073

NPI assigned

Jan 16, 2024

Organization subpart

No

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

Authorized official

Name

Amber Blacknall, DNP, PMHNPNPI 1447967435

Title

Owner

Phone

(505) 316-5966

Specialties & licenses 1

Addresses

Other names 1

• On The Mend MH Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amber Lauren Blacknall, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
  • NPI 1447967435
  NPD Authorized official

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1669233789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARQUETTE AVE NW STE 1219",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871025340",
            "telephone_number": "505-316-5966",
            "fax_number": "505-422-4073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 MARQUETTE AVE NW STE 1219",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871025340",
            "telephone_number": "505-316-5966",
            "fax_number": "505-422-4073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUSTANG MANAGEMENT GROUP TR",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BLACKNALL",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-316-5966",
        "authorized_official_credential": "DNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "On The Mend MH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary Damian Muscarella, DDS
• Jason Muscari, FNP
• Musello Partnership, LLC
• Kate M Musello, M.D., PH.D.
• Ciara Musser, CNP
• Jon R Mustonen, DO
• Isabella Marie Muth, PA
• Mohan Muvvala, DO
• Diane Muzenjak, CNP
• Mvi Surgery Center,LLC

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.