Provider Demographics
NPI:1962823914
Name:GORZEMAN, BRANDI (RN)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:GORZEMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2845
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-2845
Mailing Address - Country:US
Mailing Address - Phone:575-303-2929
Mailing Address - Fax:575-233-6260
Practice Address - Street 1:530 N TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8243
Practice Address - Country:US
Practice Address - Phone:575-303-2929
Practice Address - Fax:752-336-2605
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-18
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NM74019363L00000X
NMR41405163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WS0200XNursing Service ProvidersRegistered NurseSchool