Active NPI
Brian Wyaco
- Registered Nurse
- Gallup, NM
National Provider Identifier
1093624801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 79770
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1000
- NPI assigned
- Sep 7, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 79770 | NM | Primary |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
PO Box 723
Zuni, NM 87327-0723
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1093624801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 723",
"city": "ZUNI",
"state": "NM",
"postal_code": "873270723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 E NIZHONI BLVD",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015748",
"telephone_number": "505-722-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYACO",
"first_name": "BRIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-07",
"last_updated": "2026-09-07",
"certification_date": "2026-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "79770",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.