Healthcare Provider Details

I. General information

NPI: 1598964116
Provider Name (Legal Business Name): DENISE MARIE KIELPINSKI CPM,LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 07/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 ARKANSAS ST SE
RIO RANCHO NM
87124-3265
US

IV. Provider business mailing address

520 ARKANSAS ST SE
RIO RANCHO NM
87124-3265
US

V. Phone/Fax

Practice location:
  • Phone: 505-891-7827
  • Fax:
Mailing address:
  • Phone: 505-891-7827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number01417 R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: