Healthcare Provider Details

I. General information

NPI: 1720064835
Provider Name (Legal Business Name): TANYA T BRYNDZIA CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 COMMERCIAL DR SE
RIO RANCHO NM
87124-4040
US

IV. Provider business mailing address

PO BOX 221530
EL PASO TX
79913-4530
US

V. Phone/Fax

Practice location:
  • Phone: 505-264-9961
  • Fax: 505-289-3887
Mailing address:
  • Phone: 505-264-9961
  • Fax: 505-289-3887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number201898
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-01899
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAPRN9319861
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: