Brenda L Carabajal

Individual provider Active NPI Registered Nurse · Grants, NM

NPI 1669093977 · NPPES record last updated Apr 28, 2020

Key facts

NPI
1669093977
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
46069 (NM)
Practice address
200 W Santa Fe Ave
Grants, NM 87020-2530
Phone
(505) 287-5483
NPI assigned
Apr 28, 2020
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

State licenses

LicenseStateTypeSpecialty
46069NMMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 46069 NM Yes

Addresses

Primary practice location

200 W Santa Fe Ave
Grants, NM 87020-2530

Mailing address

1831 Alif Rd NE
Rio Rancho, NM 87144-1586
Phone (505) 879-4802

Other identifiers

IdentifierTypeStateIssuer
616784300OtherNMDOL PROVIDER NUMBER

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL microsoft Direct
Other URL email Direct

Other providers in Grants, NM

All providers in Grants, NM · Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.