Provider Demographics
NPI:1669501276
Name:HUNTLEY, CHRISTINE TRUBIC (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:TRUBIC
Last Name:HUNTLEY
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 MARIE PARK DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1718
Mailing Address - Country:US
Mailing Address - Phone:505-400-2861
Mailing Address - Fax:
Practice Address - Street 1:813 MARIE PARK DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1718
Practice Address - Country:US
Practice Address - Phone:505-400-2861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR45856364SP0809X
TX09874364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult