Healthcare Provider Details

I. General information

NPI: 1457873382
Provider Name (Legal Business Name): CYNTHIA BLUHM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 07/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 CEDAR ST SE STE 7600
ALBUQUERQUE NM
87106
US

IV. Provider business mailing address

283 EL CONEJO ST
LOS ALAMOS NM
87544-2428
US

V. Phone/Fax

Practice location:
  • Phone: 505-563-2718
  • Fax: 505-563-2708
Mailing address:
  • Phone: 505-695-5117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR61351
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: