Organization
FAMILY HEALTH CLINIC OF NEW MEXICO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BRAZIL FNP-BC (CERTIFIED FAMILY NURSE PRACTITIONER)
(505) 469-0730
Entity
Organization
Contact information
Practice address
3911 4TH ST NW, ALBUQUERQUE, NM 87107-2510
(505) 469-0730
Mailing address
3911 4TH ST NW, ALBUQUERQUE, NM 87107-2510
(505) 469-0730
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP00707
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154419117
INDIVIDUAL NPI
NM
Enumeration date
11/04/2011
Last updated
11/04/2011
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