Individual
BRANDY DAWN HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C APRN
Contact information
Practice address
4801 MCMAHON BLVD NW STE 245, ALBUQUERQUE, NM 87114-5478
(505) 315-3541
(505) 445-4904
Mailing address
PO BOX 44308, RIO RANCHO, NM 87174-4308
(505) 315-3541
(505) 445-4904
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP54278
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNP54278
CNP LICENSE
NM
01
—
CS00226579
NM CONTROLLED SUBSTANCE
NM
01
—
RN81953
RN LICENSE
NM
Enumeration date
11/21/2018
Last updated
07/01/2024
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