Healthcare Provider Details

I. General information

NPI: 1992671770
Provider Name (Legal Business Name): AUDREY TAKEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AUDREY GARCIA

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6709 ACADEMY RD NE STE A
ALBUQUERQUE NM
87109-3363
US

IV. Provider business mailing address

4516 ARROWHEAD AVE NW
ALBUQUERQUE NM
87114-3465
US

V. Phone/Fax

Practice location:
  • Phone: 505-841-1234
  • Fax:
Mailing address:
  • Phone: 832-605-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number87757
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: