Healthcare Provider Details

I. General information

NPI: 1326886631
Provider Name (Legal Business Name): JACQUELINE KANE BABBITT HEALTH COACH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2024
Last Update Date: 07/19/2024
Certification Date: 07/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9711 WILSHIRE AVE NE
ALBUQUERQUE NM
87122-3031
US

IV. Provider business mailing address

9711 WILSHIRE AVE NE
ALBUQUERQUE NM
87122-3031
US

V. Phone/Fax

Practice location:
  • Phone: 505-328-3298
  • Fax: 505-596-7774
Mailing address:
  • Phone: 505-328-3298
  • Fax: 505-596-7774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: