Healthcare Provider Details

I. General information

NPI: 1205901824
Provider Name (Legal Business Name): ANCHORING LIGHT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 UPTOWN BLVD NE STE 650
ALBUQUERQUE NM
87110-4186
US

IV. Provider business mailing address

6100 UPTOWN BLVD NE STE 650
ALBUQUERQUE NM
87110-4186
US

V. Phone/Fax

Practice location:
  • Phone: 505-340-0700
  • Fax:
Mailing address:
  • Phone: 505-340-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberR47327
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code364SH1100X
TaxonomyHolistic Clinical Nurse Specialist
License NumberR47327
License Number StateNM

VIII. Authorized Official

Name: LESLIE TUCHMANN
Title or Position: CLINICAL NURSE SPECIALIST
Credential: CNS
Phone: 505-340-0700