Individual
BRIANA CHACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6621 GULTON CT NE, ALBUQUERQUE, NM 87109-4407
(505) 888-0443
(505) 888-1398
Mailing address
809 JEFFERSON ST NE, ALBUQUERQUE, NM 87110-6205
(505) 620-9299
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA2019-0094
NM
363A00000X
Physician Assistant
Primary
PA2019-0094
NM
Other
Enumeration date
11/11/2019
Last updated
10/28/2021
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