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General NPI Number Information
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NPI Number | 1871891101
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Entity Type | Individual
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Provider Name | MARTHA CAROL ANDREW LM, CPM
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Gender | Female
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 188 MIRANDA CANYON ROAD
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City | RANCHOS DE TAOS
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State | NM
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Zip | 87557
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Country | US
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Telephone | 575-751-7430
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1671
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City | RANCHOS DE TAOS
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State | NM
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Zip | 87557-1671
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Country | US
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Telephone | 575-751-7430
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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 | 175M00000X
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Taxonomy Name | Lay Midwife
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License Number | 96368R
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License Number State | NM
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