Healthcare Provider Details

I. General information

NPI: 1639007370
Provider Name (Legal Business Name): ANGELIQUE STEADMAN LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3509 STARDUST DR NE
ALBUQUERQUE NM
87110-1498
US

IV. Provider business mailing address

3167 SAN MATEO BLVD NE # 183
ALBUQUERQUE NM
87110-1921
US

V. Phone/Fax

Practice location:
  • Phone: 505-710-7916
  • Fax:
Mailing address:
  • Phone: 505-710-7916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number26002R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: