Healthcare Provider Details

I. General information

NPI: 1457699001
Provider Name (Legal Business Name): ARIELE BAUERS RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4705 MONTGOMERY BLVD NE STE 301
ALBUQUERQUE NM
87109
US

IV. Provider business mailing address

4705 MONTGOMERY BLVD NE STE 301
ALBUQUERQUE NM
87109-1234
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-4500
  • Fax: 505-727-4505
Mailing address:
  • Phone: 505-727-4500
  • Fax: 505-727-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number55838
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number701
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number77129
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number777330
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: