Healthcare Provider Details

I. General information

NPI: 1366690315
Provider Name (Legal Business Name): NANCY ELEANOR BREW ANP-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 CALLE DE VALDEZ
SANTA FE NM
87505-7335
US

IV. Provider business mailing address

621 CALLE DE VALDEZ
SANTA FE NM
87505-7335
US

V. Phone/Fax

Practice location:
  • Phone: 907-314-2472
  • Fax:
Mailing address:
  • Phone: 907-314-2472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number67447
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number315
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number67447
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number315
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: