Healthcare Provider Details

I. General information

NPI: 1306314596
Provider Name (Legal Business Name): ALAYSHA HORNE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1219
US

IV. Provider business mailing address

4101 INDIAN SCHOOL RD NE STE 101
ALBUQUERQUE NM
87110-3988
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number930
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4704432752
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: