Provider Demographics
NPI:1831367382
Name:REDONDO CLADERA, MARIA TERESA (CFNP/CNM)
Entity type:Individual
Prefix:
First Name:MARIA TERESA
Middle Name:
Last Name:REDONDO CLADERA
Suffix:
Gender:F
Credentials:CFNP/CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 MONTEREY PL
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3864
Mailing Address - Country:US
Mailing Address - Phone:505-231-1581
Mailing Address - Fax:
Practice Address - Street 1:1691 GALISTEO ST STE D
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4781
Practice Address - Country:US
Practice Address - Phone:505-954-1921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR45930363LF0000X
NM573367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily