Provider Demographics
NPI:1093540932
Name:BURRIEL, MATHEW (RN)
Entity type:Individual
Prefix:
First Name:MATHEW
Middle Name:
Last Name:BURRIEL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 TESORO LOOP NW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-8974
Mailing Address - Country:US
Mailing Address - Phone:505-948-7701
Mailing Address - Fax:
Practice Address - Street 1:2502 MARBLE AVE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:800-690-0934
Practice Address - Fax:806-900-9340
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-84431163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine