Chen Brautigan, RN
Individual provider Active NPI Registered Nurse · Gallup, NM
NPI 1154965002 · NPPES record last updated Nov 4, 2019
Key facts
- NPI
- 1154965002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 74191 (OK)
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1000
- NPI assigned
- Nov 4, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74191 | OK | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 74191 | OK | Yes |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone (505) 722-1000
Other providers in Gallup, NM
- Tamara Deanne Brand
- Laura Nicole Brandon
- Kadallah Zizwee Brandy
- Ray Harris Branson
- George Brasinikas
- Frances Marie Bravo
- Cleo Brazier
- Jennifer Breedlove
- Dawn Miller Brett
- Sarah Bridge
All providers in Gallup, NM · Registered Nurse 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 4, 2019. 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.