MRS. JAREN P GRAVAGNE CNP RNFA NPI 1689063323

NPI Information

  • NPI: 1689063323
  • Provider Name: MRS. JAREN P GRAVAGNE, CNP, RNFA
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4901 LANG AVE NE
    ALBUQUERQUE, NM
    ZIP 87109
  • Phone: (505) 842-8171

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NPI Details

MRS. Jaren P Gravagne, CNP, RNFA is a nurse practitioner in Albuquerque, NM with 9 years of experience. The provider is (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. MRS. Jaren P Gravagne, CNP, RNFA NPI is 1689063323. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4901 LANG AVE NE
ALBUQUERQUE, NM
ZIP 87109-397
Phone: (505) 842-8171
Fax: (505) 246-0684

The NPI 1689063323 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Hernia repair (minimally invasive) (HCPCS:NAN16)

The enumeration date for this NPI number is 1/19/2015 and was last updated on 5/26/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163W00000XRegistered NurseR57758NEW MEXICONo
2163WR0006XRegistered NurseRegistered Nurse First AssistantR57758NEW MEXICONo
3363LF0000XNurse PractitionerFamilyCNP-02956NEW MEXICONo
4363L00000XNurse PractitionerCNP-02956NEW MEXICOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CNP-02956OTHERNEW MEXICOCERTIFIED NURSE PRACTIONER LICENSE
2R57758OTHERNEW MEXICORN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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