Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 549 | NM |
NPI | 1043301633 |
---|---|
Provider Name | Kathleen Garza |
First Address | Alamogordo, NM 88310-8703 |
Second Address | Alamogordo, NM 88310-8703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
549 | CNM LICENSE (01) | NM |
593000 | REGISTERED NURSE LICENSE (01) | TX |