Minuteclinic Diagnostic of New Mexico, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

MINUTECLINIC DIAGNOSTIC OF NEW MEXICO, LLC

Practice address

4340 San Mateo Blvd NE
Albuquerque, NM 87110-1234

Phone

(866) 389-2727

NPI assigned

Jun 1, 2022

Organization subpart

No

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

Authorized official

Name

Deborah Jean Pincince

Title

Administrator

Phone

(401) 770-3813

Specialties & licenses 3

Addresses

Tax ID family

Minuteclinic Diagnostic of New Mexico LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Minuteclinic Diagnostic of New Mexico, LLC

  • Clinical Social Worker
  • Albuquerque, NM
  • NPI 1396591228
  NPD tax ID

Locations

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1942949664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 SAN MATEO BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871101234",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINUTECLINIC DIAGNOSTIC OF NEW MEXICO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-01",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-770-3813"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Minor
• Erin Mintle, FNP
• Violet Hope Mintle
• Minuteclinic Diagnostic of New Mexico, LLC
• Minuteclinic Diagnostic of New Mexico, LLC
• Joanna Rull Mioduszewski
• Mathilde Elise Miquel, LCSW
• Fazia Ahmed Mir, M.D
• Mira Consulting, Incorporated
• Darlene Lynn Mirabal, CPSW

• Family Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, 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 4, 2025; 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.