Healthcare Provider Details

I. General information

NPI: 1346559432
Provider Name (Legal Business Name): ANDREA MARIE ESCHEN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2010
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DR MARTIN LUTHER KING JR AVE NE LOVELACE MEDICAL CENTER
ALBUQUERQUE NM
87102-3619
US

IV. Provider business mailing address

6100 PAN AMERICAN EAST FWY NE SUITE 100
ALBUQUERQUE NM
87109-3427
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-8206
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP02739
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: