MEDICARE: CHRISTINA RACQUEL SOLBERG PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	71614	NM

General Provider Information

NPI Number	:	1366158479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA RACQUEL SOLBERG PMHNP-BC

Provider Business Mailing Address
First Line	:	4505 HIGHWAY 180 E
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7768
Country	:	US
Telephone Number	:	575-590-1496
Fax Number	:

Provider Business Practice Location Address
First Line	:	4505 HIGHWAY 180 E
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7768
Country	:	US
Telephone Number	:	575-590-1496
Fax Number	:

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

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	12/31/2025

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