Healthcare Provider Details

I. General information

NPI: 1235041328
Provider Name (Legal Business Name): ANNA DOCTEUR FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST STE N9A
SANTA FE NM
87505-2111
US

IV. Provider business mailing address

2019 GALISTEO ST STE N9A
SANTA FE NM
87505-2111
US

V. Phone/Fax

Practice location:
  • Phone: 505-820-1482
  • Fax:
Mailing address:
  • Phone: 505-820-1482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number69830
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: