Healthcare Provider Details

I. General information

NPI: 1922438092
Provider Name (Legal Business Name): STEPHANIE SANCHEZ RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2013
Last Update Date: 11/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 JOURNAL CENTER BLVD NE 1ST FLOOR WOMEN'S HEALTH
ALBUQUERQUE NM
87109-5900
US

IV. Provider business mailing address

5150 JOURNAL CENTER BLVD NE 1ST FLOOR WOMEN'S HEALTH
ALBUQUERQUE NM
87109-5900
US

V. Phone/Fax

Practice location:
  • Phone: 505-262-3589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-46734
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: