Healthcare Provider Details

I. General information

NPI: 1013903871
Provider Name (Legal Business Name): KAREN SPIELBUSCH CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 01/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CONSTITUTION AVE NE
ALBUQUERQUE NM
87110-7613
US

IV. Provider business mailing address

7700 VENICE AVE NE
ALBUQUERQUE NM
87122
US

V. Phone/Fax

Practice location:
  • Phone: 505-559-6100
  • Fax:
Mailing address:
  • Phone: 505-828-1935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR18549
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP00269
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: