Healthcare Provider Details

I. General information

NPI: 1740149558
Provider Name (Legal Business Name): CHRISTINE ALISE HAHN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 UNSER BLVD SE
RIO RANCHO NM
87124-3392
US

IV. Provider business mailing address

10729 CLYBURN PARK DR NE
ALBUQUERQUE NM
87123-4867
US

V. Phone/Fax

Practice location:
  • Phone: 505-253-7878
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number55471
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number55471
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: