Provider Demographics
NPI:1568966604
Name:DUDENHOEFFER, MARIA LISA (CPNP-AC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LISA
Last Name:DUDENHOEFFER
Suffix:
Gender:F
Credentials:CPNP-AC
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Mailing Address - Street 1:933 BRADBURY DR SE STE 2222
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4375
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2719
Practice Address - Country:US
Practice Address - Phone:505-272-5551
Practice Address - Fax:505-272-6845
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2023-06-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMCNP-03524363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care