Provider Demographics
NPI:1932912904
Name:CARDER, TERESA
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:CARDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 EMILIO LOPEZ RD NW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7082
Mailing Address - Country:US
Mailing Address - Phone:505-865-4646
Mailing Address - Fax:505-866-4796
Practice Address - Street 1:1776 EMILIO LOPEZ RD NW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-7082
Practice Address - Country:US
Practice Address - Phone:505-865-4646
Practice Address - Fax:505-866-4796
Is Sole Proprietor?:No
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide