Individual
THERESE HIDALGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1619 W. DELGADO, BELEN HIGH SCHOOL-BASED HEALTH CENTER, BELEN, NM 87002
(505) 966-1381
(505) 966-1385
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R18189
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000L6495
—
NM
Enumeration date
10/03/2006
Last updated
05/06/2009
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