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General NPI Number Information
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NPI Number | 1326896994
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Entity Type | Individual
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Provider Name | MEGAN BOONE CNM
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Gender | Female
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Dates
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Enumeration Date | 05/09/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 4701 MONTGOMERY BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1219
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Country | US
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Telephone | 505-727-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MULBERRY ST NE UNIT 2020
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4770
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Country | US
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Telephone | 248-881-4071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 263701
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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