BANYAN TREE MIND & WELLNESS NPI 1215873690

NPI Information

  • NPI: 1215873690
  • Provider Name: BANYAN TREE MIND & WELLNESS
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 1740 GRANDE BLVD SE STE B2
    RIO RANCHO, NM
    ZIP 87124
  • Phone: (505) 750-0656

Map and Directions

Get Directions

NPI Details

BANYAN TREE MIND & WELLNESS is a psychiatric/mental health nurse practitioner in Rio Rancho, NM. BANYAN TREE MIND & WELLNESS NPI is 1215873690. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1740 GRANDE BLVD SE STE B2
RIO RANCHO, NM
ZIP 87124-799
Phone: (505) 750-0656

The provider's authorized official is Mary Ruffaner Hanson .
The authorized official title is Pmhnp-bc and has the following contact phone number (505) 301-5153.

The enumeration date for this NPI number is 4/27/2026 and was last updated on 4/27/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.