Herzog, Nina Jean

Herzog, Nina Jean is an individual health care provider with primary practice located at 8208 Louisiana Blvd Ne Suite C, Albuquerque NM 87113-1757. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Herzog, Nina Jean can be contacted via phone (505) 858-1222.

Contact Information

Primary practice address
8208 Louisiana Blvd Ne Suite C Albuquerque NM 87113-1757
Phone: (505) 858-1222
Fax: (505) 858-1224
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X R49167 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X CNP01217 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R49167 New Mexico

Profile Details

NPI number 1780730440
LBN Legal business name Herzog, Nina Jean
Credentials ACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2007
Last updated May 20th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780730440 NPPES
Texas Other R49167 BNE LICENSE
Texas Other 2006009954 BNE LICENSE
Texas MEDICAID 87657317 BNE LICENSE

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