Provider Demographics
NPI:1427147735
Name:HESSER, BRIAN R (DC, CNP)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:R
Last Name:HESSER
Suffix:
Gender:M
Credentials:DC, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 E LOHMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8273
Mailing Address - Country:US
Mailing Address - Phone:575-521-0793
Mailing Address - Fax:575-532-1607
Practice Address - Street 1:3850 E LOHMAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8273
Practice Address - Country:US
Practice Address - Phone:575-521-0793
Practice Address - Fax:575-532-1607
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1453111N00000X
NMCNP-01801363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
348701602Medicare PIN