Terri P Elisberg, R.D.,L.D.,C.D.E.
Individual provider Active NPI Registered Dietitian · Tijeras, NM
NPI 1881865558 · NPPES record last updated Nov 2, 2011
Key facts
- NPI
- 1881865558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 059 (NM)
- Practice address
- 47 Villacitos Rd
Tijeras, NM 87059-6601 - Phone
- (505) 450-9961
- NPI assigned
- Mar 20, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059 | NM | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pueblo of Isleta | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 059 | NM | Yes |
Addresses
Primary practice location
47 Villacitos Rd
Tijeras, NM 87059-6601
Mailing address
PO Box 998
Tijeras, NM 87059
Phone (505) 450-9961
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 059 | Other | NM | LICENSE |
Other providers in Tijeras, NM
- Kimberyly Collins
- Kathryn Conticelli
- Robert O. Costa
- Holly Diedrich
- Patricia A Drey
- Enchanted Healing of New Mexico LLC
- Essence of Life Therapy and Wellness, LLC
- Eileen Farrell
- Quentin Cooper Florence
- Forging Ahead Therapies, Inc.
All providers in Tijeras, NM · Registered Dietitian in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.