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General NPI Number Information
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NPI Number | 1255409728
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Entity Type | Organization
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Legal Business Name | NANCY LEHRHAUPT CNP LLC
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4 DUENDE RD
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City | SANTA FE
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State | NM
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Zip | 87508-2247
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Country | US
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Telephone | 505-660-4399
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Fax | 505-466-3132
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Provider Business Mailing Address
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Address Line | PO BOX 24304
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City | SANTA FE
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State | NM
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Zip | 87502
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Country | US
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Telephone | 505-660-4399
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Fax | 505-466-3132
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Authorized Official
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Title or Position | NURSE PRACTITIONER MANAGER
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Name | MS. NANCY CAROL LEHRHAUPT
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Credential | CNP
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Telephone | 505-660-4399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R42279
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License Number State | NM
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