Nicole Danielle Mansour, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

82459 Issued in NM

Practice address

3949 Corrales Rd Ste 105
Corrales, NM 87048-9347

Phone

(949) 820-1743

Fax

(847) 221-6782

NPI assigned

Jan 22, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Blooming Cactus Wellness, LLCGroup PAC ID 5991108680, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Blooming Cactus Wellness LLC

  • Primary Care Nurse Practitioner
  • Albuquerque, NM
  • NPI 1477127264
  Medicare reassignment Care Compare group NPD
• Americas Health and Wellness LLC

  • Family Nurse Practitioner
  • Corrales, NM
  • NPI 1881588564
  NPD (past)

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

{
    "created_epoch": "1737504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1689486003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 GARDEN RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871242431",
            "telephone_number": "505-459-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3949 CORRALES RD STE 105",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489347",
            "telephone_number": "949-820-1743",
            "fax_number": "847-221-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "NICOLE",
        "middle_name": "DANIELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-22",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "82459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loving Hands Supportive Living, LLC
• Markus Maceo Sr., INTERN
• Wayne Rowan Maes, PH.D.
• Karen A Mahan, LCSW MSW 4346123
• Donalita Grace Maloney, PH.D.
• Carmen Martinez Tittmann, MA LPCC LMSW
• Kaitlyn J Martinez
• Mary Hobbs Psychotherapy LLC
• Michael A Mauldin, PH.D.
• Angel Carmillia McKinstry Ramsey

• Family Nurse Practitioner in Corrales, NM
• Providers in Corrales, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.