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General NPI Number Information
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NPI Number | 1760907679
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Entity Type | Individual
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Provider Name | CASSANDRIA RENEE BRANCH NP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 08/11/2017
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Provider Practice Location Address
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Address Line | 2450 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-5141
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Country | US
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Telephone | 575-521-2286
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Fax |
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Provider Business Mailing Address
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Address Line | 512 PANORAMA BLVD
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City | ALAMOGORDO
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State | NM
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Zip | 88310-7221
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Country | US
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Telephone | 575-921-2680
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CNP-03341
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License Number State | NM
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