Organization
INTEGRATIVE & PERSONALIZED HORMONE THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA BLANCO DNP, APRN (OWNER)
(915) 217-9300
Entity
Organization
Contact information
Practice address
5290 MCNUTT RD STE 105, SANTA TERESA, NM 88008-9648
(575) 502-3303
(575) 205-0254
Mailing address
5290 MCNUTT RD STE 105, SANTA TERESA, NM 88008-9648
(575) 502-3303
(575) 205-0254
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNP-02155
MEDICAL LICENSE
NM
Enumeration date
12/12/2016
Last updated
11/20/2025
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