Individual provider · Type 1 NPI

Desiree Renee Provencio, DNP, CNP, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Albuquerque, NM

NPI number 1336648328 Active

Practice location

9384 Valley View Dr NW Ste 400
Albuquerque, NM 87114-4403

Fax (505) 207-7988

Mailing address

PO Box 45450
Rio Rancho, NM 87174-5450

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808XCNP-03491 (NM)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1336648328

Desiree Renee Provencio, DNP, CNP, PMHNP-BC's National Provider Identifier is 1336648328, issued on Feb 6, 2018. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Albuquerque, NM. The record was last updated on Nov 18, 2025.