Healthcare Provider Details

I. General information

NPI: 1215197876
Provider Name (Legal Business Name): ANNETTE VIGNOGNA BROWNE, GNP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 CAMINO BARRANCA
PLACITAS NM
87043-9335
US

IV. Provider business mailing address

PO BOX 93282
ALBUQUERQUE NM
87199-3282
US

V. Phone/Fax

Practice location:
  • Phone: 505-867-7206
  • Fax: 505-867-7206
Mailing address:
  • Phone: 505-867-7206
  • Fax: 505-867-7206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP01442
License Number StateNM

VIII. Authorized Official

Name: MS. ANNETTE MARIE VIGNOGNA BROWNE
Title or Position: NURSE PRACTITIONER
Credential: GNP
Phone: 505-867-7206