Rudy Brown, NURSE
Individual provider Active NPI Registered Nurse · Espanola, NM
NPI 1306078852 · NPPES record last updated Aug 18, 2009
Key facts
- NPI
- 1306078852
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- L19869 (NM)
- Practice address
- 104 Los Alamos Hwy
Espanola, NM 87532-2747 - Phone
- (505) 747-8187
- Fax
- (505) 747-8306
- NPI assigned
- Aug 18, 2009
- Sex
- Male
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L19869 | NM | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Una Ala Clinic, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | L19869 | NM | Yes |
Addresses
Primary practice location
104 Los Alamos Hwy
Espanola, NM 87532-2747
Mailing address
104 Los Alamos Hwy
Espanola, NM 87532-2747
Phone (505) 747-8781
Other providers in Espanola, NM
- Marian Clair Bradbury
- Katlyn Maegan Brantley
- Breath of My Heart
- Breath of My Heart Birthplace
- Antonio Thomas Brecevich
- Desiree Bustos
- Rebecca Miran Cadden
- Karen M Cain
- Suzanne Call
- Jessica Lynn Callaway
All providers in Espanola, 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 Aug 18, 2009. 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.