Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 254 | NM |
NPI | 1134152721 |
---|---|
Provider Name | Elizabeth Tertia Heath-West |
First Address | Albuquerque, NM 87125 |
Second Address | Albuquerque, NM 87109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 02/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
93443 | (05) | NM |
R82843 | (02) |