Healthcare Provider Details

I. General information

NPI: 1871214957
Provider Name (Legal Business Name): HALEY MARGARET CROWDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST STE Q
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

1708 MONTANO ST # C1
SANTA FE NM
87505-0788
US

V. Phone/Fax

Practice location:
  • Phone: 831-425-8132
  • Fax:
Mailing address:
  • Phone: 707-372-7634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: