Healthcare Provider Details

I. General information

NPI: 1154859882
Provider Name (Legal Business Name): THERESA MARIE TOOMEY NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 JOURNAL CENTER BLVD NE
ALBUQUERQUE NM
87109-5900
US

IV. Provider business mailing address

2929 COORS BLVD NW
ALBUQUERQUE NM
87120-1173
US

V. Phone/Fax

Practice location:
  • Phone: 505-262-3233
  • Fax:
Mailing address:
  • Phone: 505-839-2303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-03083
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: