MEDICARE: MRS. EVA ELIZABETH HOUGHTON FNP-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	163W00000X	Registered Nurse	172614	CO
2	363LF0000X	Family Nurse Practitioner	CNP-01675	NM

General Provider Information

NPI Number	:	1730499211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EVA ELIZABETH HOUGHTON FNP-BC

Provider Business Mailing Address
First Line	:	8300 CARMEL AVE NE STE 303B
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87122-3125
Country	:	US
Telephone Number	:	505-594-1139
Fax Number	:

Provider Business Practice Location Address
First Line	:	8300 CARMEL AVE NE STE 303B
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87122-3125
Country	:	US
Telephone Number	:	505-594-1139
Fax Number	:

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

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	01/17/2024

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