Provider Demographics
NPI:1194140277
Name:DUKE CITY HEALTHCARE
Entity type:Organization
Organization Name:DUKE CITY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFNP/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:FURY
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:505-899-4414
Mailing Address - Street 1:4411 MONTANO RD NW
Mailing Address - Street 2:SUITE F
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3235
Mailing Address - Country:US
Mailing Address - Phone:505-899-4414
Mailing Address - Fax:505-898-2395
Practice Address - Street 1:4411 MONTANO RD NW
Practice Address - Street 2:SUITE F
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3235
Practice Address - Country:US
Practice Address - Phone:505-899-4414
Practice Address - Fax:505-898-2395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2004-0125261QP2300X
NMCNP01240261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1467535658OtherNPI
NM43129846Medicaid
NM202023190OtherPRESBYTERIAN
NM1568482701OtherNPI
NMNM006H53OtherBLUE CROSS
NMQ76696OtherUPIN
NMI23863Medicare UPIN
NMQ76696OtherUPIN