Tina Marie Gonzales

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CNP-03228 Issued in NM

Practice address

811 Saint Michaels Dr
Santa Fe, NM 87505-7641

Phone

(505) 988-2049

Fax

(505) 992-2930

NPI assigned

May 17, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871020255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 COUNTY ROAD 119",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875323502",
            "telephone_number": "505-501-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057641",
            "telephone_number": "505-988-2049",
            "fax_number": "505-992-2930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 County Road 119",
            "address_purpose": "LOCATION",
            "city": "Espanola",
            "state": "NM",
            "postal_code": "875323502",
            "country_code": "US",
            "telephone_number": "505-501-4408",
            "fax_number": "505-501-4408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard E Gonzales, SLP
• Ruby Gonzales
• Sariah E Gonzales
• Teresita Gonzales
• Thelma Jean Gonzales
• Vanessa S Gonzales
• Adrienne Gonzalez
• Fabiola A Gonzalez
• Francisco Gonzalez
• Jazzmin Melissa Gonzalez

• Family Nurse Practitioner in Santa Fe, NM
• Providers in Santa Fe, 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 Mar 17, 2018; 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.