MEDICARE: MS. TANYA THERESA BRYNDZIA 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
1	363LC0200X	Critical Care Medicine Nurse Practitioner	201898	NC
2	363L00000X	Nurse Practitioner	CNP-01899	NM
3	363LC0200X	Critical Care Medicine Nurse Practitioner	APRN9319861	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720064835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TANYA THERESA BRYNDZIA CNP

Provider Business Mailing Address
First Line	:	904 LAS LOMAS RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2633
Country	:	US
Telephone Number	:	505-924-2651
Fax Number	:	505-924-2684

Provider Business Practice Location Address
First Line	:	904 LAS LOMAS RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-2633
Country	:	US
Telephone Number	:	505-924-2651
Fax Number	:	505-924-2684

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

Provider Enumeration Date	:	12/20/2005
Last Update Date	:	07/30/2025

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