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1831617265
THERESA IRENE WUSSOW
ALBUQUERQUE, NM
NPI
1831617265
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: NM CNP-03307)
Enumeration Date
2017-09-06
Last Update Date
2017-10-05
Business Address
THERESA IRENE WUSSOW FNP-BC
1100 CENTRAL AVE SE
ALBUQUERQUE, NM 87106-4930
Phone number: 505-933-2272
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Mailing Address
THERESA IRENE WUSSOW FNP-BC
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-6770
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