Provider Demographics
NPI:1124781539
Name:CRESPIN, ELENA (DNP CNP PMHNP)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:CRESPIN
Suffix:
Gender:F
Credentials:DNP CNP PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 FLEET RD NW
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124
Mailing Address - Country:US
Mailing Address - Phone:505-917-6932
Mailing Address - Fax:
Practice Address - Street 1:6300 RIVERSIDE PLAZA LN NW STE 100
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1908
Practice Address - Country:US
Practice Address - Phone:505-595-7092
Practice Address - Fax:775-372-2185
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM65745363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health