Healthcare Provider Details

I. General information

NPI: 1285226753
Provider Name (Legal Business Name): HANNA GASPER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2021
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 PASEO DEL NORTE BLVD NE
ALBUQUERQUE NM
87113-1718
US

IV. Provider business mailing address

PO BOX 26666 PRESBYTERIAN HEALTHCARE SERVICES/PROVIDER ENROLLMENT
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-596-2100
  • Fax:
Mailing address:
  • Phone: 505-923-6770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number62817
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: