Healthcare Provider Details

I. General information

NPI: 1861340499
Provider Name (Legal Business Name): TORI LYNN BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 ROAD 3333
AZTEC NM
87410-9515
US

IV. Provider business mailing address

37 ROAD 3333
AZTEC NM
87410-9515
US

V. Phone/Fax

Practice location:
  • Phone: 505-320-8991
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number79525
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: