Healthcare Provider Details

I. General information

NPI: 1295603991
Provider Name (Legal Business Name): HEIDI HAMLEN DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 10/25/2025
Certification Date: 10/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 VALENCIA LOOP
SANTA FE NM
87508-8888
US

IV. Provider business mailing address

5 VALENCIA LOOP
SANTA FE NM
87508-8888
US

V. Phone/Fax

Practice location:
  • Phone: 505-629-7701
  • Fax: 505-466-1606
Mailing address:
  • Phone: 505-629-7701
  • Fax: 505-466-1606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number1196
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: