Individual provider · NPI-1

Katlyn Maegan Brantley

Family Medicine · Espanola, NM

NPI number1336015312
StatusActive
Last updated in NPPESJul 26, 2026

Details

NPI
1336015312
Entity type
Individual (NPI-1)
Name
Katlyn Maegan Brantley
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 15, 2025
Certification date
Jul 26, 2026
Last updated
Jul 26, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine53897NMYes

Practice location

2010 Industrial Park Rd
Espanola, NM 87532-3600

Phone 505-753-9503

Mailing address

439 Ponderosa Way
Jemez Springs, NM 87025-8036

Phone 505-240-0353

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in Espanola, NM