Wise, Kontasha Shamika
Wise, Kontasha Shamika is an sole proprietor health care provider with primary practice located at 2900 Louisiana Blvd Ne Ste J1 , Albuquerque NM 87110-3575. She recently has 5 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Wise, Kontasha Shamika can be contacted via phone (505) 554-2681.Contact Information
Primary practice address
2900 Louisiana Blvd Ne Ste J1
Albuquerque NM 87110-3575
Phone: (505) 554-2681
Fax: (505) 213-2657
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | CNP02817 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | CNP02817 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | CNP02817 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | CNP02817 | New Mexico |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 17616 | South Carolina |
Profile Details
| NPI number | 1679850044 |
|---|---|
| LBN Legal business name | Wise, Kontasha Shamika |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 12th, 2011 |
| Last updated | Jan 19th, 2024 - about last year |
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 | 1679850044 | NPPES |
| New Mexico | MEDICAID | 6929753 |
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