MEDICARE: MS. THERESA B STRASSBURGER CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	CNP00406	NM
2	163W00000X	Registered Nurse	R23449	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CNP00406	OTHER	NM	NM BOARD OF NURSING

General Provider Information

NPI Number	:	1114923695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. THERESA B STRASSBURGER CNP

Provider Business Mailing Address
First Line	:	1012 EUBANK BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-5310
Country	:	US
Telephone Number	:	505-298-4325
Fax Number	:	505-294-5407

Provider Business Practice Location Address
First Line	:	1012 EUBANK BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-5310
Country	:	US
Telephone Number	:	505-298-4325
Fax Number	:	505-294-5407

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	11/08/2013

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