Individual
TRACY LANE BRADFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
5800 MCLEOD RD NE, ALBUQUERQUE, NM 87109-2454
(505) 453-0958
(505) 422-8612
Mailing address
6704 BROADWAY BLVD NE, ALBUQUERQUE, NM 87107-5911
(505) 453-0958
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02695
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50575716
—
NM
Enumeration date
08/13/2015
Last updated
03/07/2023
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