Individual
MS. MILDRED BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCHW
Contact information
Practice address
PO BOX 279, JEMEZ PUEBLO, NM 87024-0279
(575) 834-7207
(575) 834-7119
Mailing address
PO BOX 279, JEMEZ PUEBLO, NM 87024-0279
(575) 834-7207
(575) 834-7119
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
S1-088
NM
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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