=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568375749
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARTWOOD HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2026
-----------------------------------------------------
Last Update Date | 09/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 608 CIELO GRANDE
-----------------------------------------------------
City | SANTA FE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87505-6967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-233-1568
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 608 CIELO GRANDE
-----------------------------------------------------
City | SANTA FE
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 87505-6967
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-233-1568
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CNM/APRN, OWNER
-----------------------------------------------------
Name | ABIGAIL S LUNDBERG
-----------------------------------------------------
Credential | CNM, APRN
-----------------------------------------------------
Telephone | 802-233-1568
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------