Individual
KATLYN MAEGAN BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 INDUSTRIAL PARK RD, ESPANOLA, NM 87532-3600
(505) 753-9503
Mailing address
439 PONDEROSA WAY, JEMEZ SPRINGS, NM 87025-8036
(505) 240-0353
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53897
NM
Other
Enumeration date
10/15/2025
Last updated
02/13/2026
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