Healthcare Provider Details

I. General information

NPI: 1033250329
Provider Name (Legal Business Name): KATHLEEN ANN LEMONE LICENSED MIDWIFE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 MISSOURI AVE SUITE 12
LAS CRUCES NM
88011-5075
US

IV. Provider business mailing address

14626 N VALLEY DR
LAS CRUCES NM
88007-6141
US

V. Phone/Fax

Practice location:
  • Phone: 505-522-6900
  • Fax: 505-522-8891
Mailing address:
  • Phone: 505-636-4627
  • Fax: 505-522-8891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number7029 R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: