National Provider Identifier Database

JUDY LIESVELD, CNP – NPI #1295707651
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.


Contact Information

JUDY LIESVELD, CNP
2111 COLLEGE DR
REHOBOTH MCKINLEY CHRISTIAN HEALTH CARE SERVICES
GALLUP, NM87301-5600
Phone: 505-863-1820
Fax:
Website:
Specialty Taxonomy Code
* Nurse Practitioner 363L00000X

* Indicates primary specialty

NPI Profile & details for JUDY LIESVELD

NPI Number 1295707651
Credentials CNP (Certified Nurse Practitioner)
Entity Individual
Enumeration date 02/01/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • NM License #: R30234
  • AZ Medicaid: 469066
  • NM Medicaid: 99628
  • Other: 85031326887301A120 CHAMPUS
  • NM Other: NM006180 BC/BS
  • NM Other: 10002112 LOVELACE HEALTH/SALUD
  • NM Other: PROVP14473 MOLINA
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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