Provider Demographics
NPI:1083181051
Name:ROMERO, BRITTENI NICOLE (PA)
Entity Type:Individual
Prefix:
First Name:BRITTENI
Middle Name:NICOLE
Last Name:ROMERO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4950 ORTEGA RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7410
Mailing Address - Country:US
Mailing Address - Phone:575-654-9725
Mailing Address - Fax:
Practice Address - Street 1:4351 E LOHMAN AVE STE 310
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8258
Practice Address - Country:US
Practice Address - Phone:575-532-9755
Practice Address - Fax:575-532-8881
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMPA2018-0085363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical