Healthcare Provider Details

I. General information

NPI: 1457639262
Provider Name (Legal Business Name): MAYIMRAPHA COMPREHENSIVE HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4253 MONTGOMERY BLVD NE STE 220
ALBUQUERQUE NM
87109-1130
US

IV. Provider business mailing address

PO BOX 27453
ALBUQUERQUE NM
87125-7453
US

V. Phone/Fax

Practice location:
  • Phone: 505-881-5307
  • Fax: 505-908-3816
Mailing address:
  • Phone: 505-881-5307
  • Fax: 505-908-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MELANIE UKANWA
Title or Position: OWNER/PHYSICIAN PROVIDER
Credential: MD
Phone: 505-881-5307