MEDICARE: NATURAL WOMENS HEALTH LLC

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	261QP2300X	Primary Care Clinic/Center	R17788	NM
2	363L00000X	Nurse Practitioner	R17788	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295915346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURAL WOMENS HEALTH LLC

Provider Business Mailing Address
First Line	:	4550 EUBANK BLVD NE
Second Line	:	STE 105
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-2565
Country	:	US
Telephone Number	:	505-296-1120
Fax Number	:	505-296-0718

Provider Business Practice Location Address
First Line	:	4550 EUBANK BLVD NE
Second Line	:	STE 105
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-3479
Country	:	US
Telephone Number	:	505-296-1120
Fax Number	:	505-296-0718

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. JEANETTE WEILER
Credential	:	CPC
Telephone Number	:	505-433-2755

Provider Enumeration Date	:	11/06/2007
Last Update Date	:	08/12/2011

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Directions to “NATURAL WOMENS HEALTH LLC ” Practice Location

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