JUDITH M VERGARA-BLAKE CNP NPI 1730169699

NPI Information

  • NPI: 1730169699
  • Provider Name: JUDITH M VERGARA-BLAKE, CNP
  • Classification: Registered Nurse - 163WW0101X
  • Specialization: Women's Health Care, Ambulatory
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1500 WALTER ST SE
    ALBUQUERQUE, NM
    ZIP 87102
  • Phone: (505) 272-1393

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NPI Details

Judith M Vergara-blake, CNP is a women's health care and ambulatory registered nurse in Albuquerque, NM with 23 years of experience. Judith M Vergara-blake, CNP NPI is 1730169699. 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:

1500 WALTER ST SE
ALBUQUERQUE, NM
ZIP 87102-658
Phone: (505) 272-1393
Fax: (505) 272-2177

The NPI 1730169699 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 enumeration date for this NPI number is 1/18/2006 and was last updated on 7/5/2023.

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
1163WW0101XRegistered NurseWomen's Health Care, AmbulatoryR51480NEW 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
175502330MEDICAIDNEW MEXICO

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: 11/21/2025

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