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NPI Code Detail

MEDICARE: MRS. BRUNA BRUM WYNNE APRN-CNP

MEDICARE: MRS. BRUNA BRUM WYNNE APRN-CNP
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
1363LA2100XAcute Care Nurse Practitioner60956NM

General Provider Information

NPI Number : 1467061895
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRUNA BRUM WYNNE APRN-CNP
Provider Business Mailing Address
First Line : 800 BRADBURY DR SE STE 116
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-4310
Country : US
Telephone Number : 505-272-1476
Fax Number :
Provider Business Practice Location Address
First Line : 933 BRADBURY DR SE STE 2204
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-4375
Country : US
Telephone Number : 505-272-3201
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2020
Last Update Date : 02/16/2026

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Directions to “ MRS. BRUNA BRUM WYNNE APRN-CNP” Practice Location

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