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5800 Mcleod Rd Ne, Albuquerque, NM 87109-2454 | |
(505) 453-0958 | |
(505) 422-8612 |
Full Name | |
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Type | Facility |
Speciality | Nurse Practitioner - Primary Care |
Location | 5800 Mcleod Rd Ne, Albuquerque, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1689190357 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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171100000X | Acupuncturist | 1198 (New Mexico) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | CNP-02695 (New Mexico) | Primary |
Provider Name | Tracy Lane Bradfield |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659747681 PECOS PAC ID: 0840556072 Enrollment ID: I20171106000097 |
Mailing Address | Practice Location Address |
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6704 Broadway Blvd Ne, Albuquerque, NM 87107-5911 Ph: (505) 453-0958 | 5800 Mcleod Rd Ne, Albuquerque, NM 87109-2454 Ph: (505) 453-0958 |