Angela M Kisner, DOM, FNP-CB, BSN-RN is a medicare enrolled "Nurse Practitioner - Family" provider in Albuquerque, New Mexico. Her current practice location is
1501 San Pedro Dr Se, Albuquerque, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 265-1711.
Angela M Kisner is licensed to practice in New Mexico (license number 54175) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609004910.
Healthcare Provider's Profile
Full Name | Angela M Kisner |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 1501 San Pedro Dr Se, Albuquerque, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1609004910
- Provider Enumeration Date: 06/25/2009
- Last Update Date: 03/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 3173993201
- Enrollment ID: I20230105000973
Medical Identifiers
Medical identifiers for Angela M Kisner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1609004910 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
171100000X | Acupuncturist | 992 (New Mexico) | Secondary |
261QV0200X | Clinic/center - Va | 54175 (New Mexico) | Secondary |
363LF0000X | Nurse Practitioner - Family | 54175 (New Mexico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angela M Kisner is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Angela M Kisner, DOM, FNP-CB, BSN-RN 9805 Rio Corto Ave Sw, Albuquerque, NM 87121-2628 Ph: (505) 803-3623 | Angela M Kisner, DOM, FNP-CB, BSN-RN 1501 San Pedro Dr Se, Albuquerque, NM 87108-5154 Ph: (505) 265-1711 |
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