MEDICARE: MS. KAREN C O'DAY CNM, CFNP, MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R25968	NM
2	367A00000X	Advanced Practice Midwife	462	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	201032100	OTHER	NM	PRESBYTERIAN HEALTH/SALUD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	00NM006227	OTHER	NM	BLUE CROSS BLUE SHIELD
5	68638	OTHER	NM	PRESBYTERIAN HEALTH/SALUD
6	850482276	OTHER	NM	OTHER INSURANCES

General Provider Information

NPI Number	:	1164483962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN C O'DAY CNM, CFNP, MBA

Provider Business Mailing Address
First Line	:	1911 5TH ST
Second Line	:	SUITE 101
City	:	SANTA FE
State	:	NM
Zip	:	87505-5403
Country	:	US
Telephone Number	:	505-780-8301
Fax Number	:	505-780-5418

Provider Business Practice Location Address
First Line	:	1911 5TH ST
Second Line	:	SUITE 101
City	:	SANTA FE
State	:	NM
Zip	:	87505-5403
Country	:	US
Telephone Number	:	505-780-8301
Fax Number	:	505-780-5418

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2006
Last Update Date	:	03/17/2017

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