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General NPI Number Information
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NPI Number | 1760348288
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Entity Type | Individual
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Provider Name | SANDRA LYNN SIEBUHR LICENSED NURSE
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Gender | Female
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Dates
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Enumeration Date | 12/29/2025
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 2720 CENTRAL AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-2862
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Country | US
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Telephone | 505-559-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 425 69TH ST SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87121-2457
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Country | US
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Telephone | 918-289-0270
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Fax |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | L11249
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License Number State | NM
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