Individual
THERESA E NUSSBAUMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
650 E INDIAN SCHOOL RD, PHOENIX, AZ 85012-1839
(602) 277-5551
Mailing address
5901 HARPER DR NE, ALBUQUERQUE, NM 87109-3587
(505) 823-8870
(505) 823-8875
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
CNP-02139
NM
364SA2200X
Adult Health Clinical Nurse Specialist
CNS-00237
NM
Other
Enumeration date
05/10/2013
Last updated
02/17/2015
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