Provider Demographics
NPI:1780983304
Name:KLEINSTEUBER, KATHERINE (CNP)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:KLEINSTEUBER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:DE LOS SANTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2402 W PIERCE ST STE 5C
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-3567
Mailing Address - Country:US
Mailing Address - Phone:575-725-5755
Mailing Address - Fax:575-725-5753
Practice Address - Street 1:2402 W PIERCE ST STE 5C
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-3567
Practice Address - Country:US
Practice Address - Phone:575-725-5755
Practice Address - Fax:575-725-5753
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125670363LA2100X
NMCNP-02266363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351213902Medicaid
NMR55193OtherNM NURSING LICENSE
TX371906YKYCMedicare PIN