Healthcare Provider Details

I. General information

NPI: 1023917556
Provider Name (Legal Business Name): MAMMANA MIDWIFERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2026
Last Update Date: 11/02/2026
Certification Date: 11/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4133 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-6741
US

IV. Provider business mailing address

2510 RIO GRANDE BLVD NW
ALBUQUERQUE NM
87104-3224
US

V. Phone/Fax

Practice location:
  • Phone: 505-375-1397
  • Fax: 505-431-4774
Mailing address:
  • Phone: 505-415-0403
  • Fax: 505-431-4774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name: RACHEL BRUNACINI
Title or Position: OWNER, MIDWIFE
Credential: LM, CPM
Phone: 505-415-0403