Individual
BRIANA LYNN WEISENBURGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
401 SAN MATEO BLVD SE, ALBUQUERQUE, NM 87108
(505) 462-7333
(505) 888-1082
Mailing address
401 SAN MATEO BLVD. SE, ALBUQUERQUE, NM 87108
(505) 462-7333
(505) 888-1082
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2016-0056
NM
363AM0700X
Medical Physician Assistant
PA2016-0056
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08770085
—
NM
Enumeration date
08/02/2016
Last updated
12/12/2022
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