Healthcare Provider Details

I. General information

NPI: 1033095609
Provider Name (Legal Business Name): MICHELLE M ABEYTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1194 SAINT FRANCIS LN UNIT 3
TAOS NM
87571-8240
US

IV. Provider business mailing address

PO BOX 351
RANCHOS DE TAOS NM
87557-0351
US

V. Phone/Fax

Practice location:
  • Phone: 575-779-2828
  • Fax:
Mailing address:
  • Phone: 575-779-2828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: