Healthcare Provider Details

I. General information

NPI: 1598146243
Provider Name (Legal Business Name): CHRISTINA NOEL ULIBARRI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA NOEL TRUJILLO M.D.

II. Dates (important events)

Enumeration Date: 06/17/2015
Last Update Date: 08/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 S PACHECO ST
SANTA FE NM
87505-3997
US

IV. Provider business mailing address

550 UNIVERSITY BLVD STE 2440
INDIANAPOLIS IN
46202-5149
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-0303
  • Fax: 505-984-1116
Mailing address:
  • Phone: 317-948-5923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11018453A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD2019-0657
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: