Healthcare Provider Details

I. General information

NPI: 1376407973
Provider Name (Legal Business Name): VUELTA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7208 VUELTA DE LA LUZ
SANTA FE NM
87507-1841
US

IV. Provider business mailing address

7208 VUELTA DE LA LUZ
SANTA FE NM
87507-1841
US

V. Phone/Fax

Practice location:
  • Phone: 615-417-4049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL RYAN BRISON
Title or Position: OWNER
Credential: CNP
Phone: 615-417-4049