Healthcare Provider Details

I. General information

NPI: 1285471680
Provider Name (Legal Business Name): CALEY BRYN SKROCH DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7015 CANYON CLIFF RD NW
ALBUQUERQUE NM
87114-6139
US

IV. Provider business mailing address

7015 CANYON CLIFF RD NW
ALBUQUERQUE NM
87114-6139
US

V. Phone/Fax

Practice location:
  • Phone: 505-321-8444
  • Fax:
Mailing address:
  • Phone: 505-321-8444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number87764
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number81073
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: