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General NPI Number Information
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NPI Number | 1386197507
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Entity Type | Individual
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Provider Name | TINA BORNSCHEUER PMHNP, FNP
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Gender | Female
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Dates
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Enumeration Date | 07/25/2016
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 2960 RODEO PARK DR W
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City | SANTA FE
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State | NM
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Zip | 87505-6351
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Country | US
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Telephone | 770-605-6491
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Fax |
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Provider Business Mailing Address
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Address Line | 4801 LANG AVE NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4475
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Country | US
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Telephone | 505-475-1555
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Fax | 505-672-7924
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | CNP-03013
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-03013
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | RN114940
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP-03013
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License Number State | NM
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