MEDICARE: GRISELDA BARAJAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	75661	NM

General Provider Information

NPI Number	:	1952249427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRISELDA BARAJAS

Provider Business Mailing Address
First Line	:	5324 SOLE GRANDE RD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-3988
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 LOMAS BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-2719
Country	:	US
Telephone Number	:	505-272-2111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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Directions to “ GRISELDA BARAJAS ” Practice Location

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