Individual
MS. THERESE A LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3400 ALPHA CT NW, ALBUQUERQUE, NM 87120-1202
(505) 836-6592
Mailing address
3400 ALPHA CT NW, ALBUQUERQUE, NM 87120-1202
(505) 836-6592
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R20466
NM
Other
Enumeration date
02/19/2007
Last updated
10/21/2010
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