Healthcare Provider Details

I. General information

NPI: 1114099124
Provider Name (Legal Business Name): NANCY CAROL LEHRHAUPT CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 DUENDE RD
SANTA FE NM
87508-2247
US

IV. Provider business mailing address

PO BOX 24304
SANTA FE NM
87502
US

V. Phone/Fax

Practice location:
  • Phone: 505-660-4399
  • Fax: 505-986-8028
Mailing address:
  • Phone: 505-660-4399
  • Fax: 505-986-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR42279
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP00969
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: