Healthcare Provider Details

I. General information

NPI: 1497611610
Provider Name (Legal Business Name): 41 WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2025
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 13TH ST SE
RIO RANCHO NM
87124-3529
US

IV. Provider business mailing address

1401 13TH ST SE
RIO RANCHO NM
87124-3529
US

V. Phone/Fax

Practice location:
  • Phone: 505-488-1014
  • Fax:
Mailing address:
  • Phone: 505-488-1014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: KATIE SCHMIERER
Title or Position: DIRECTOR
Credential: RN
Phone: 505-488-1014