MS. THERESA ANN BUBENZER (NPI# 1811025703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811025703 |
| Entity Type | Individual |
| Full Name | MS. THERESA ANN BUBENZER |
| Credential | FNP |
| Practice Address |
3917 West Rd Ste A Los Alamos NM 87544-2292 |
| Practice Telephone | 5056618900 |
| Practice Fax Number | 5056618916 |
| Mailing Telephone | 5056618900 |
| Mailing Fax Number | 5056618916 |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2015-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | RN-75785 | NM | Nursing Service Providers |
| Y | 363L00000X | Nurse Practitioner | CNP-01998 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
71002349A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | STATE LICENSE | CNP-01998 | 01 |
| IN | NP LICENSE | 71002349A | 01 |
| Street Address |
3917 WEST RD STE A |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544-2292 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528073384 | Heather Ellen Marancenbaum | Family Medicine | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2006-07-30 |
| 1588217749 | Pema L Tamang | Family Medicine | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2019-07-17 |
| 1619449766 | Jordan A Lichthardt | Dietitian, Registered | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2018-12-28 |
| 1760964506 | Leigh Barham | Family Medicine | 3917 West Rd Ste A, Los Alamos, NM 87544 | 2018-08-29 |
| 1124512207 | Michelle Certik | Physician Assistant | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2018-06-21 |
| 1457881625 | Sara E Mcevers | Nurse Practitioner | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2017-06-19 |
| 1750720306 | Elena Soliz Mcatee | Family Medicine | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2013-06-17 |
| 1487962031 | Linda Taylor | Physician Assistant | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2010-09-16 |
| 1861540437 | Ann K Ferris | Internal Medicine | 3917 West Rd Ste A, Los Alamos, NM 87544-2275 | 2007-01-08 |
| 1740337146 | Mara Trainer | Nurse Practitioner | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2007-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457881625 | Sara E Mcevers | Nurse Practitioner | 3917 West Rd Ste A, Los Alamos, NM 87544-2292 | 2017-06-19 |
| 1013378272 | Deborah Hardin | Nurse Practitioner | 118 Central Park Sq, Los Alamos, NM 87544-4021 | 2016-03-16 |
| 1194968081 | National Sinus Institute Pllc | Nurse Practitioner | 3917 West Rd, Los Alamos, NM 87544-2275 | 2009-04-08 |
| 1649300781 | Karen Miller | Nurse Practitioner | 3917 West Rd, Suite A, Los Alamos, NM 87544-2275 | 2007-03-07 |
| 1194740555 | Joan Q Mcclelland | Nurse Practitioner | 3917 West Rd, Suite 150, Los Alamos, NM 87544-2275 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790742 | Marisa Moses | Nurse Practitioner | 301 Doe Ct Ne, Rio Rancho, NM 87124-2577 | 2020-08-13 |
| 1720606882 | Mountain Desert Health LLC | Nurse Practitioner | 2200 Panola St Sw, Albuquerque, NM 87121-2582 | 2020-07-06 |
| 1851915961 | Jennifer Leandra Alterson | Nurse Practitioner | 1111 10th St # 469, Alamogordo, NM 88310-6413 | 2020-06-04 |
| 1912538844 | Lorine Derusha | Nurse Practitioner | 625 Silver Ave Sw Fl 2, Albuquerque, NM 87102-3123 | 2020-01-29 |
| 1447899463 | Brenda Lee Fuselier | Nurse Practitioner | 530 S Roosevelt Road V, Portales, NM 88130-9121 | 2019-12-23 |
| 1295374247 | Thomas William Cox | Nurse Practitioner | 12812 Constitution Ave Ne Apt 2, Albuquerque, NM 87112-6142 | 2019-12-21 |
| 1730720632 | Carmen Caterina Marcolina | Nurse Practitioner | 4201 Central Ave Nw # 3, Albuquerque, NM 87105-1630 | 2019-10-01 |
| 1528617446 | Nm Stem Cell, LLC | Nurse Practitioner | 4111 Barbara Loop Se # C-2, Rio Rancho, NM 87124-1068 | 2019-09-04 |
| 1851955488 | Vanessa Marie Tapia | Nurse Practitioner | 4365 Malaga St, Las Cruces, NM 88011-4341 | 2019-04-29 |
| 1700349834 | Heather Marie Pink | Nurse Practitioner | 7802b Ironwood Ct Se, Albuquerque, NM 87116-1135 | 2019-04-06 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.