Healthcare Provider Details

I. General information

NPI: 1669304101
Provider Name (Legal Business Name): TIMOTHY W HESS NC, NTS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12900 ANTELOPE DANCER TRL NE
ALBUQUERQUE NM
87112-4802
US

IV. Provider business mailing address

PO BOX 51535
ALBUQUERQUE NM
87181-1535
US

V. Phone/Fax

Practice location:
  • Phone: 505-507-0753
  • Fax:
Mailing address:
  • Phone: 505-507-0753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: