Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 10030033 | |
Y | 176B00000X | Midwife | 13115R | NM |
NPI | 1134448939 |
---|---|
Provider Name | Miss Dorothy Reeves Kaeck |
First Address | Ranchos De Taos, NM 87557-9789 |
Second Address | Ranchos De Taos, NM 87557-9789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 24/02/2014 |