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Organization

TAOS HOMEBIRTH & MIDWIFERY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NICOLE MAILLIS LM, CPM (MIDWIFE LM, CPM)
(575) 751-4690
Entity
Organization

Contact information

Practice address
5540 NDCBU, TAOS, NM 87571-6122
(575) 770-1470
(575) 751-4690
Mailing address
5540 NDCBU, TAOS, NM 87571-6122
(575) 770-1470
(575) 751-4690

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
09060R
NM
176B00000X
Midwife
09064R
NM

Other

Enumeration date
08/29/2011
Last updated
08/29/2011
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