Healthcare Provider Details

I. General information

NPI: 1740191733
Provider Name (Legal Business Name): MIDWIVES AT THE EDGES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WILLOW BACK RD
SANTA FE NM
87508-1484
US

IV. Provider business mailing address

PO BOX 4573
SANTA FE NM
87502-4573
US

V. Phone/Fax

Practice location:
  • Phone: 843-481-5034
  • Fax:
Mailing address:
  • Phone: 843-481-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CARRIE BLAKE
Title or Position: EXECUTIVE DIRECTOR
Credential: LM, MPH
Phone: 843-481-5034