Healthcare Provider Details

I. General information

NPI: 1508027988
Provider Name (Legal Business Name): NATALIE BRUNO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHRISTUS ST VINCENT REGIONAL MEDICAL CENTER 455 ST MICHAELS DRIVE
SANTA FE NM
87505
US

IV. Provider business mailing address

1013 CAMINO SAN ACACIO
SANTA FE NM
87505-5954
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-3361
  • Fax:
Mailing address:
  • Phone: 832-886-7423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number237768
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD2022-0917
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: