Provider Demographics
NPI:1437485893
Name:BROTHERS, SVETLANA (NP)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:BROTHERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5951 JEFFERSON ST NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3450
Mailing Address - Country:US
Mailing Address - Phone:505-898-2468
Mailing Address - Fax:
Practice Address - Street 1:5951 JEFFERSON ST NE
Practice Address - Street 2:SUITE C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3450
Practice Address - Country:US
Practice Address - Phone:505-898-2468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01536363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner