Healthcare Provider Details

I. General information

NPI: 1285429902
Provider Name (Legal Business Name): LEAH FAY RAGSDALE MSN-PH, BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2025
Last Update Date: 04/12/2025
Certification Date: 04/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3451 CANDELARIA RD NE
ALBUQUERQUE NM
87107-1956
US

IV. Provider business mailing address

131 FIVE HILLS DR
TIJERAS NM
87059-7384
US

V. Phone/Fax

Practice location:
  • Phone: 505-721-7187
  • Fax:
Mailing address:
  • Phone: 505-249-9114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN-78471
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: