Corrie Booqua, RN
Individual provider Active NPI Administrator Registered Nurse · Gallup, NM
NPI 1992684492 · NPPES record last updated Aug 28, 2025
Key facts
- NPI
- 1992684492
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Administrator Registered Nurse 163WA2000X
- License
- R36475 (NM)
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1000
- NPI assigned
- Aug 28, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R36475 | NM | MD | Administrator Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | R36475 | NM | Yes |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000
Other providers in Gallup, NM
- April L Bonds
- Rebecca Ann Bongers
- Bonney Home Inc
- Rebecca Lynn Boone
- Lorelia Booqua-Pooacha
- Dianne Bordas
- Loretta Sue Boshart
- Bruce Bouchard
- Mario Bouchard
- Althea Bowekaty
All providers in Gallup, NM · Administrator Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.