Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Anne Ethridge

Individual provider Family Nurse Practitioner · NPI 1467005140

Lisa Anne Ethridge is a Nurse Practitioner in Albuquerque, New Mexico. Qualified in 2019, 7 years ago. Practices with St Vincent Hospital, a 332-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in New Mexico.

Years since qualifying
7
Licensed in
NM
In the registry since
2019
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1625 Rio Bravo Blvd SW Ste 36
Albuquerque, NM 87105-6060
Phone: (505) 777-3004
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 328 Main St Ne, Los Lunas, NM 87031-7454 — (505) 916-5446

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 57020 (NM)

Record details

NPI number1467005140
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 22, 2019
Last updated in NPPESDecember 28, 2022
Certification dateDecember 28, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice St Vincent Hospital — 332 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Albuquerque