Rebecca Anne Otero-Granger, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

CNP-02087 Issued in NM

Practice address

111 Isleta Blvd SW
Albuquerque, NM 87105-3896

Phone

(505) 200-2647

Fax

(505) 200-2695

NPI assigned

Nov 29, 2012

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354147200000",
    "number": "1871838078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 N MESA RD",
            "city": "BELEN",
            "state": "NM",
            "postal_code": "870028528",
            "telephone_number": "505-350-1035",
            "fax_number": "505-200-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ISLETA BLVD SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871053896",
            "telephone_number": "505-200-2647",
            "fax_number": "505-200-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO-GRANGER",
        "first_name": "REBECCA",
        "middle_name": "ANNE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2012-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP-02087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eseohe Osunbor
• Sue Ellen Ota, O.T.R.
• Jacqueline Otake
• Otel PLLC
• Ernesto R Otero Lopez, MD
• Crystal Otero-Griffith, CNP
• Andrea Nicole Otero-Looney, MAC
• Roselynn Otero-Whitacre, MOTR/L
• Alice L Otero, LMHC
• Cayla Otero, SLP-CF

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.