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General NPI Number Information
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NPI Number | 1871847046
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Entity Type | Organization
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Legal Business Name | NATURAL BIRTH MIDWIFERY
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 123 WELLESLEY DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1443
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Country | US
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Telephone | 505-266-5762
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Fax | 505-268-7500
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Provider Business Mailing Address
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Address Line | 123 WELLESLEY DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1443
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Country | US
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Telephone | 505-266-5762
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Fax | 505-268-7500
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Authorized Official
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Title or Position | OWNER
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Name | MS. CONNIE KOSHEWA
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Credential | LM, CPM, MPH
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Telephone | 505-266-5762
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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 | 04008R
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License Number State | NM
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