Provider Demographics
NPI:1114099124
Name:LEHRHAUPT, NANCY CAROL (CNP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:CAROL
Last Name:LEHRHAUPT
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24304
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502
Mailing Address - Country:US
Mailing Address - Phone:505-660-4399
Mailing Address - Fax:505-986-8028
Practice Address - Street 1:4 DUENDE RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-2247
Practice Address - Country:US
Practice Address - Phone:505-660-4399
Practice Address - Fax:505-986-8028
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR42279363LA2200X
NMCNP00969363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMP00217033OtherRR MEDICARE
NMZ5036Medicaid
NM344512702Medicare ID - Type Unspecified
S77159Medicare UPIN