LISA CANDELARIA (NPI# 1649671918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649671918 |
| Entity Type | Individual |
| Full Name | LISA CANDELARIA |
| Credential | CNP |
| Practice Address |
2200 W 21st St Clovis NM 88101-2011 |
| Mailing Address |
Po Box 26666 Phs Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5757697577 |
| Practice Fax Number | 5757696395 |
| Mailing Telephone | 5059236770 |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2020-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | CNP-02501 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP-02501 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 83671757 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2301 N Mlk Blvd, Clovis, NM 881019401 | 5757624455 | 5759355455 |
| 304 S Main Ave, Portales, NM 88130 | 5752263023 | 5752263024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396176236 | Lisa Candelaria | Social Worker | 489 Washington St Ste 200, Auburn, MA 01501-5709 | 2013-12-03 |
| Street Address |
2200 W 21ST ST |
| City | CLOVIS |
| State | NM |
| Zip Code | 88101-2011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053397497 | Presbyterian Healthcare Services | Medicare Defined Swing Bed Unit | 2200 W 21st St, Clovis, NM 88101-2011 | 2005-12-19 |
| 1457781759 | Matthew Laumbach | Physician Assistant | 2200 W 21st St, Clovis, NM 88101-2011 | 2013-11-22 |
| 1073870432 | Raena Singh | Family Medicine | 2200 W 21st St, Clovis, NM 88101-2011 | 2012-04-23 |
| 1407086705 | Jaya D Bathina | Internal Medicine | 2200 W 21st St, Clovis, NM 88101-2011 | 2009-07-21 |
| 1043304413 | Arnel Anthony S Bobadilla | Internal Medicine | 2200 W 21st St, Plains Regional Medical Group, Clovis, NM 88101-2011 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 1285274878 | Keishla Cota | Physical Therapist | 100 East Manana Blvd, Unit 1, Clovis, NM 88101 | 2020-01-10 |
| 1659927283 | Ndeye Ndour | Nurse Anesthetist, Certified Registered | 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 | 2019-08-09 |
| 1679132468 | Justine Nicole Nunez | Nurse Practitioner | 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 | 2019-06-06 |
| 1518453521 | Moore Psychological Services, Pllc | Social Worker | 1908 West 21st Street, Clovis, NM 88101 | 2018-07-03 |
| 1912494006 | Raesha Russell | Behavior Technician | 214 West 9th St, Clovis, NM 88101 | 2018-04-16 |
| 1013425800 | Vanessa Yardley | Registered Nurse | 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 | 2018-01-16 |
| 1699204230 | Olivia Garcia | Technician, Other | 1100 W 21st Street, Clovis, NM 88101 | 2017-06-07 |
| 1578006250 | Mary Ellen Gray | Technician, Other | 9408 B Vermont Court, Clovis, NM 88101 | 2016-11-29 |
| 1205296977 | Malaney Harmon | Behavioral Analyst | 2700 E 7th St., Clovis, NM 88101 | 2016-02-24 |
| Find all providers in zip 88101 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760095194 | Osena Health Connect | Nurse Practitioner | 1192 Carson Ave, Clovis, CA 93611-8595 | 2020-08-25 |
| 1093142697 | Stacey Melissa Montes | Nurse Practitioner | 729 N Medical Ctr Dr West, Suite 205, Clovis, CA 93611 | 2013-09-27 |
| 1083924906 | Lorilee Perry | Nurse Practitioner | 2746 Roberts Ave, Clovis, CA 93611-8545 | 2010-10-13 |
| 1467541011 | Linda Land | Nurse Practitioner | 275 W Herndon Avenue, Clovis, CA 93612 | 2006-10-12 |
| 1417571258 | Aaron Lockmiller | Nurse Practitioner | 2301 N Mlk Blvd, Clovis, NM 88101-9401 | 2020-06-07 |
| 1679196133 | Micah Pinasco | Nurse Practitioner | 604 N Magnolia Ave Ste 100, Clovis, CA 93611-9205 | 2020-05-19 |
| 1760019806 | Fnu Harsimrat Kaur | Nurse Practitioner | 55 Shaw Ave Ste 207, Clovis, CA 93612-3819 | 2020-03-26 |
| 1285297192 | Cecilia Tran | Nurse Practitioner | 726 N Medical Center Dr E Ste 209, Clovis, CA 93611-6886 | 2019-04-16 |
| 1225513088 | Courtney Nicole Williams | Nurse Practitioner | 2100 N Martin Luther King Jr. Blvd, Clovis, NM 88101 | 2018-09-27 |
| 1295246056 | Erica Castillo | Nurse Practitioner | 785 Medical Center Drive West, 203, Clovis, CA 93611 | 2017-10-19 |
| Find all providers in CLOVIS | ||||
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| 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.