Healthcare Provider Details

I. General information

NPI: 1033242292
Provider Name (Legal Business Name): GEORGE MARIE DRESDEN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. GEORGE MARIE DRESDEN-RADER

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4273 MONTGOMERY BLVD NE SUITE 200 EAST
ALBUQUERQUE NM
87109-6748
US

IV. Provider business mailing address

700 HIGH ST NE
ALBUQUERQUE NM
87102-2565
US

V. Phone/Fax

Practice location:
  • Phone: 505-821-5992
  • Fax: 505-821-6692
Mailing address:
  • Phone: 505-224-4444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP00473
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR25455
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: