Healthcare Provider Details

I. General information

NPI: 1841903036
Provider Name (Legal Business Name): SARA LORRAINE CHEVALLIER CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4133 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-6741
US

IV. Provider business mailing address

3613 SOLDOTNA DR NE
RIO RANCHO NM
87144-5658
US

V. Phone/Fax

Practice location:
  • Phone: 505-930-5641
  • Fax:
Mailing address:
  • Phone: 951-454-8571
  • Fax: 505-393-5165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number22005R
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number22005R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: