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:
Health care specialties
| Specialty | Code | License # | 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 9 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780730440 | NPPES |
| Texas | Other | R49167 | BNE LICENSE |
| Texas | Other | 2006009954 | BNE LICENSE |
| Texas | MEDICAID | 87657317 | BNE LICENSE |
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