Individual
MS. BREAWNNA BLAESING WUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1331 GUSDORF RD, TAOS, NM 87571-6282
(575) 758-3601
(505) 579-4669
Mailing address
1331 GUSDORF RD, TAOS, NM 87571-6282
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN-79465
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
79552
NM
Other
Enumeration date
08/17/2023
Last updated
03/27/2026
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