Individual
BRENDA Y PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 B VETERANS BLVD, ACOMA, NM 87034
(505) 552-5300
(505) 552-5490
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5300
(505) 552-5490
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2007-0046
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
01/11/2008
Last updated
07/14/2023
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