Healthcare Provider Details

I. General information

NPI: 1255409728
Provider Name (Legal Business Name): NANCY LEHRHAUPT CNP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
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: 505-466-3132
Mailing address:
  • Phone: 505-660-4399
  • Fax: 505-466-3132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. NANCY CAROL LEHRHAUPT
Title or Position: NURSE PRACTITIONER MANAGER
Credential: CNP
Phone: 505-660-4399