Individual
BRANDON MICHAEL BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1001 MENAUL BLVD NE, ALBUQUERQUE, NM 87107-1642
(575) 621-8918
Mailing address
1111 CARRIZO ST NW, LOS LUNAS, NM 87031-6934
(575) 621-8918
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN-90590
NM
163WE0003X
Emergency Registered Nurse
Primary
RN-90590
NM
163WF0300X
Flight Registered Nurse
RN-90590
NM
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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