Provider Demographics
NPI:1255409728
Name:NANCY LEHRHAUPT CNP LLC
Entity type:Organization
Organization Name:NANCY LEHRHAUPT CNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:LEHRHAUPT
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:505-660-4399
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:505-466-3132
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:505-466-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR42279363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMDD2513OtherRR MEDICARE
NMZ5036Medicaid
NMDD2513OtherRR MEDICARE