Individual
MICHAEL R BRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2901 TRANSPORT ST SE, ALBUQUERQUE, NM 87106
(505) 262-7110
(505) 262-7308
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 262-7110
(505) 262-7308
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP-03044
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
62851764
—
NM
Enumeration date
08/31/2016
Last updated
02/01/2024
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