Healthcare Provider Details

I. General information

NPI: 1023360575
Provider Name (Legal Business Name): ERASICLEIA TZAMALOUKAS CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2336
  • Fax: 505-925-1191
Mailing address:
  • Phone: 505-272-1476
  • Fax: 505-925-1191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberCNS-00238
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: