Organization
VDEX DIABETES NM-BROWN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE SHARON BROWN CNP (PROVIDER)
(303) 483-8967
Entity
Organization
Contact information
Practice address
1811 N RIVERSIDE DR STE C, ESPANOLA, NM 87532-9550
(505) 747-0506
(505) 747-0507
Mailing address
1811 N RIVERSIDE DR STE C, ESPANOLA, NM 87532-9550
(505) 747-0506
(505) 747-0507
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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