Healthcare Provider Details

I. General information

NPI: 1922978469
Provider Name (Legal Business Name): TEEGAN MACHEMEHL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TEEGAN FULTON

II. Dates (important events)

Enumeration Date: 11/10/2025
Last Update Date: 11/19/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6911 TAYLOR RANCH RD NW STE C8
ALBUQUERQUE NM
87120-2962
US

IV. Provider business mailing address

6911 TAYLOR RANCH RD NW STE C8
ALBUQUERQUE NM
87120-2962
US

V. Phone/Fax

Practice location:
  • Phone: 505-218-7321
  • Fax:
Mailing address:
  • Phone: 505-218-7321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: