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Contact Information

JAREN P GRAVAGNE, CNP, RNFA
4901 LANG AVE NE
ALBUQUERQUE, NM87109-4397
 Phone: 505-842-8171
 Fax: 505-246-0684
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
 

Registered Nurse First Assistant

163WR0006X
Indicates primary specialty

NPI Profile & details for JAREN P GRAVAGNE · (Female)

NPI Number 1689063323
Status Active
Credentials CNP, RNFA
Entity Individual
Enumeration date 01/19/2015
Last updated 05/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NM License # CNP-02956
  • NM License # R57758
  • NM Other CNP-02956 CERTIFIED NURSE PRACTIONER LICENSE
  • NM Other R57758 RN LICENSE
Hospital affiliation(s)
  • PRESBYTERIAN HOSPITAL - (Acute Care)
    1100 CENTRAL AVENUE SE
    ALBUQUERQUE, NM 87106
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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