MEDICARE: ST FRANCIS HEALTH CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	83-PA013	NM
2	207Q00000X	Family Medicine Physician	97382	NM
3	175M00000X	Lay Midwife	80021R	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285731414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST FRANCIS HEALTH CENTER

Provider Business Mailing Address
First Line	:	1494 SOUTH ST FRANCIS DRIVE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4038
Country	:	US
Telephone Number	:	505-983-7276
Fax Number	:	505-983-5017

Provider Business Practice Location Address
First Line	:	1494 SOUTH ST FRANCIS DRIVE
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4038
Country	:	US
Telephone Number	:	505-983-7276
Fax Number	:	505-983-5017

Authorized Official
Title or Position	:	OWNER
Name	:	LENYA REESE
Credential	:	P.A., L.M.
Telephone Number	:	505-983-7276

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/23/2008

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Directions to “ST FRANCIS HEALTH CENTER ” Practice Location

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