Healthcare Provider Details

I. General information

NPI: 1639493869
Provider Name (Legal Business Name): CHRISTIN SHIVANI LASH CPM LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 S SAINT FRANCIS DR
SANTA FE NM
87505-4035
US

IV. Provider business mailing address

2224 CAMBRIDGE DR
SARASOTA FL
34232-3816
US

V. Phone/Fax

Practice location:
  • Phone: 413-441-3466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number22003R
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: