Individual
BRENDA LEE FUSELIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP-APRN
Contact information
Practice address
304 S MAIN AVE, PORTALES, NM 88130-6218
(575) 226-3023
(575) 226-3024
Mailing address
PO BOX 55, PORTALES, NM 88130-0055
(575) 226-3023
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
60176
NM
363LF0000X
Family Nurse Practitioner
60176
NM
363LF0000X
Family Nurse Practitioner
R43905
NM
Other
Enumeration date
12/23/2019
Last updated
07/01/2021
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