Healthcare Provider Details

I. General information

NPI: 1568375749
Provider Name (Legal Business Name): HEARTWOOD HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

608 CIELO GRANDE
SANTA FE NM
87505-6967
US

IV. Provider business mailing address

608 CIELO GRANDE
SANTA FE NM
87505-6967
US

V. Phone/Fax

Practice location:
  • Phone: 802-233-1568
  • Fax:
Mailing address:
  • Phone: 802-233-1568
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL

VIII. Authorized Official

Name: ABIGAIL S LUNDBERG
Title or Position: CNM/APRN, OWNER
Credential: CNM, APRN
Phone: 802-233-1568