Individual
JORGE LUIS BRENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111
Mailing address
5122 ENSENADA PL NW, ALBUQUERQUE, NM 87107-3820
(505) 670-6742
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
82477
NM
Other
Enumeration date
11/20/2024
Last updated
02/14/2025
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