Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | CNP-01638 | NM |
NPI | 1104134949 |
---|---|
Provider Name | Ms. Andrea Breznay Harrell |
First Address | Albuquerque, NM 87106-2745 |
Second Address | Albuquerque, NM 87106-2745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2010 |
Last Update Date | 14/09/2010 |