Loretta Lucy Brazil, RN BSN

Individual provider Active NPI Registered Nurse · Cimarron, NM

NPI 1891200937 · NPPES record last updated Dec 12, 2017

Key facts

NPI
1891200937
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R15228 (NM)
Practice address
132 N Collison Ave
Cimarron, NM 87714-8500
Phone
(575) 376-2512
Fax
(575) 376-2217
NPI assigned
Dec 12, 2017
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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R15228NMMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R15228 NM Yes

Addresses

Primary practice location

132 N Collison Ave
Cimarron, NM 87714-8500

Mailing address

805 Adams Ave
Cimarron, NM 87714-9628
Phone (575) 376-2622

Other providers in Cimarron, NM

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

Sources for this page

Verify at the official NPI Registry.