Healthcare Provider Details

I. General information

NPI: 1427939115
Provider Name (Legal Business Name): KIHCI WOMBWORK COLLECTIVE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 MILLS DR
ROSWELL NM
88203-2408
US

IV. Provider business mailing address

212 S LEA AVE
ROSWELL NM
88203-4576
US

V. Phone/Fax

Practice location:
  • Phone: 575-347-1315
  • Fax:
Mailing address:
  • Phone: 575-347-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MRS. MAEVE ERAKIS EBRIGHT
Title or Position: DIRECTOR AND DOULA
Credential: CERTIFIED DOULA
Phone: 575-840-7615