Healthcare Provider Details

I. General information

NPI: 1083537377
Provider Name (Legal Business Name): STACY F. SANDEL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8411 TAMPICO PL
FARMINGTON NM
87402-1135
US

IV. Provider business mailing address

8411 TAMPICO PL
FARMINGTON NM
87402-1135
US

V. Phone/Fax

Practice location:
  • Phone: 505-301-6568
  • Fax:
Mailing address:
  • Phone: 505-301-6568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: STACY SANDEL
Title or Position: DOULA
Credential: C-IAYT, CLC, CLD
Phone: 505-301-6568