INTEGRATIVE & PERSONALIZED HORMONE THERAPY LLC NPI 1346784287

NPI Information

NPI: 1346784287
Provider Name: INTEGRATIVE & PERSONALIZED HORMONE THERAPY, LLC
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Organization

Specialization: Women's Health

CLIA Number: 32D2283144

Address:
1300 COUNTRY CLUB RD
A
SANTA TERESA, NM
ZIP 88008
Phone: (915) 217-9300
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INTEGRATIVE & PERSONALIZED HORMONE THERAPY, LLC is a women's health nurse practitioner in Santa Teresa, NM. INTEGRATIVE & PERSONALIZED HORMONE THERAPY, LLC NPI is 1346784287. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1300 COUNTRY CLUB RD
A
SANTA TERESA, NM
ZIP 88008-449
Phone: (915) 217-9300

The provider's authorized official is Christina Blanco .
The authorized official title is Owner and has the following contact phone number (915) 217-9300.

The CLIA number assigned to this NPI record is 32D2283144 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/12/2016 and was last updated on 12/12/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LW0102X	Nurse Practitioner	Women's Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CNP-02155	OTHER	NEW MEXICO	MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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