Healthcare Provider Details
I. General information
NPI: 1497637136
Provider Name (Legal Business Name): ECHO OF EDEN MIDWIFERY-LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3613 SOLDOTNA DR NE
RIO RANCHO NM
87144-5658
US
IV. Provider business mailing address
3613 SOLDOTNA DR NE
RIO RANCHO NM
87144-5658
US
V. Phone/Fax
- Phone: 951-454-8571
- Fax:
- Phone: 951-454-8571
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 176B00000X |
| Taxonomy | Midwife |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
SARA
L
CHEVALLIER
Title or Position: LEAD MIDWIFE
Credential: CPM,LM
Phone: 951-454-8571