Provider Demographics
NPI:1114923695
Name:STRASSBURGER, THERESA B (CNP)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:B
Last Name:STRASSBURGER
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 1:1012 EUBANK BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-5310
Mailing Address - Country:US
Mailing Address - Phone:505-298-4325
Mailing Address - Fax:505-294-5407
Practice Address - Street 1:1012 EUBANK BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5310
Practice Address - Country:US
Practice Address - Phone:505-298-4325
Practice Address - Fax:505-294-5407
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP00406363LF0000X
NMR23449163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMCNP00406OtherNM BOARD OF NURSING
NMG33130Medicare UPIN