DOMINIQUE PUMMILL (NPI# 1609364249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609364249 |
| Entity Type | Individual |
| Full Name | DOMINIQUE PUMMILL |
| Credential | PMHNP |
| Practice Address |
601 Martin Luther King Ave Ne Albuquerque NM 87102-3619 |
| Mailing Address |
Po Box 966 Fairacres NM 88033-0966 |
| Practice Telephone | 5052883173 |
| Mailing Telephone | 5758050695 |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2018-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CNP03564 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
601 MARTIN LUTHER KING AVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669433017 | William M Roethel | Emergency Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2006-03-28 |
| 1730335860 | Leslie Anne Miller | Occupational Therapist | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2008-08-08 |
| 1518137041 | Lovelace Health System Inc | Psychiatric Unit | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2008-03-12 |
| 1275711178 | Lovelace Health Systems LLC | Internal Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2008-02-04 |
| 1396779716 | Thomas Scott Pannke | Emergency Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524727 | Clarissa Juarez, LLC | Nurse Practitioner | 3900 Juan Tabo Blvd Ne Ste 4, Albuquerque, NM 87111-3978 | 2020-09-26 |
| 1053933721 | Canu Health, LLC | Nurse Practitioner | 2621 Cutler Ave Ne, Albuquerque, NM 87106-2511 | 2020-05-15 |
| 1245869130 | Indigo Psychiatric Services | Nurse Practitioner | 609 Gold Ave Sw Ste 1-c, Albuquerque, NM 87102-3119 | 2020-04-03 |
| 1194388496 | Anne E. Galanis | Nurse Practitioner | 100 Deputy Dean Miera Dr Sw: Bernalillo County Metropol, Albuquerque, NM 87151 | 2019-04-22 |
| 1790214344 | La Paloma Clinic LLC | Nurse Practitioner | 431 Gene Ave Nw, Albuquerque, NM 87107-5320 | 2017-06-07 |
| 1437493020 | Sarah Michael Workman | Nurse Practitioner | 1501 San Pedro Drive Se, Bld 47, 377mdg/mdos/sgow, Albuquerque, NM 87117 | 2012-11-20 |
| 1437407301 | Jayanna Warwick | Nurse Practitioner | 2015 Wyoming Blvd Ne, Suite F, Albuquerque, NM 87112-2622 | 2012-08-26 |
| 1780939975 | Brenda Kaye Mckenna | Nurse Practitioner | Unm Department of Psychiatry and Behavioral Health Scie, 1 University of New Mexico, Albuquerque, NM 87131 | 2012-07-13 |
| 1194091603 | Awareness Integration LLC | Nurse Practitioner | 219 Sierra Dr Se, Unit A, Albuquerque, NM 87108-2714 | 2012-03-29 |
| 1003148156 | Maureen Kolomeir | Nurse Practitioner | 5345 Wyoming Blvd, Suite 101, Albuquerque, NM 87109-3193 | 2010-01-30 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
Please comment or provide details below to improve the information on DOMINIQUE PUMMILL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.