MEDICARE: KATLYN MAEGAN BRANTLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	53897	NM

General Provider Information

NPI Number	:	1336015312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATLYN MAEGAN BRANTLEY

Provider Business Mailing Address
First Line	:	439 PONDEROSA WAY
Second Line	:
City	:	JEMEZ SPRINGS
State	:	NM
Zip	:	87025-8036
Country	:	US
Telephone Number	:	505-240-0353
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 E BOND ST
Second Line	:
City	:	ESPANOLA
State	:	NM
Zip	:	87532-2729
Country	:	US
Telephone Number	:	505-753-9503
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2025
Last Update Date	:	10/15/2025

Similar Medicare Providers

1770576134 — DR. BRENT J. VAN ANDEL M.D.
Practice Location Address:

711 BOND ST , EL CENTRO FAMILY HEALTH BOND CLINIC
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax: 505-747-1004

1700879160 — MS. XOCHITL ROMERO PA-C
Practice Location Address:

711 BOND ST
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax: 505-747-1004

1760582464 — DR. JOHN G LANG PH.D.
Practice Location Address:

721 BOND ST
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-5811
Practice Fax: 505-747-3210

1871799858 — WELLNESS CLINICAL SERVICES INC.
Practice Location Address:

721 BOND ST
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-5811
Practice Fax: 505-747-3210

1821373812 — EL CENTRO FAMILY HEALTH
Practice Location Address:

711 BOND ST.
ESPANOLA, NM
87532-2729

Practice Phone: 505-753-9503
Practice Fax: 505-747-1004

1366338568 — BLOSSOM & THRIVE THERAPY CO LLC
Practice Location Address:

745 N RIVERSIDE DR STE F
ESPANOLA, NM
87532-2889

Practice Phone: 575-770-2876
Practice Fax:

Directions to “ KATLYN MAEGAN BRANTLEY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.