Brittany N Antonio

Individual provider Active NPI Registered Nurse · Gallup, NM

NPI 1689257487 · NPPES record last updated Apr 30, 2021

Key facts

NPI
1689257487
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
58206 (NM)
Practice address
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1000
NPI assigned
Apr 30, 2021
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
58206NMMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 58206 NM Yes

Addresses

Primary practice location

516 E Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

PO Box 127
Vanderwagen, NM 87326-0127

Other providers in Gallup, NM

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

Sources for this page

Verify at the official NPI Registry.