Individual
LISA C. PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
2110 CALLE DE SAN ALBINO, MESILLA, NM 88046-8804
(575) 496-5042
Mailing address
PO BOX 1042, MESILLA, NM 88046-1042
(575) 496-5042
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
20005R
NM
Other
Enumeration date
08/19/2020
Last updated
08/19/2020
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