Healthcare Provider Details

I. General information

NPI: 1285731414
Provider Name (Legal Business Name): ST FRANCIS HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1494 SOUTH ST FRANCIS DRIVE
SANTA FE NM
87505-4038
US

IV. Provider business mailing address

1494 SOUTH ST FRANCIS DRIVE
SANTA FE NM
87505-4038
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-7276
  • Fax: 505-983-5017
Mailing address:
  • Phone: 505-983-7276
  • Fax: 505-983-5017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number83-PA013
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number97382
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number80021R
License Number StateNM

VIII. Authorized Official

Name: LENYA REESE
Title or Position: OWNER
Credential: P.A., L.M.
Phone: 505-983-7276