Individual
TODD D. HULTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
1400 CHAMA AVE, SANTA FE, NM 87505-3372
(505) 988-2211
(303) 945-7844
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
65648
NM
363L00000X
Nurse Practitioner
991803-NP
CO
363LA2100X
Acute Care Nurse Practitioner
254580
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69633517
—
CO
05
—
701211
—
MA
Enumeration date
06/17/2006
Last updated
01/03/2022
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