Individual
TAMARA M GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1234
(505) 841-1956
Mailing address
1720 LOUISIANA BLVD NE, SUITE #401, ALBUQUERQUE, NM 87110-7022
(505) 260-4300
(505) 260-4338
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
CRA-5054
CO
367500000X
Certified Registered Nurse Anesthetist
R021320
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
R63682
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67250360
—
CO
Enumeration date
07/03/2006
Last updated
07/07/2011
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