Individual
THERESE C MAESTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
8300 CONSTITUTION AVE NE., SUITE 106, ALBUQUERQUE, NM 87110-7624
(505) 291-2770
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
75249
NM
363LF0000X
Family Nurse Practitioner
75249
NM
Other
Enumeration date
08/25/2023
Last updated
11/13/2023
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