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Individual

CARRIE VALENTINE BLAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPM, LM

Contact information

Practice address
1315 S SAINT FRANCIS DR, SANTA FE, NM 87505-4035
(505) 780-5030
Mailing address
1315 S SAINT FRANCIS DR, SANTA FE, NM 87505-4035
(505) 780-5030

Taxonomy

Speciality
Code
Description
License number
State
176B00000X
Midwife
20001R
NM
176B00000X
Midwife
Primary
27
ID
176B00000X
Midwife
97
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11872716
CAQH
Enumeration date
10/02/2007
Last updated
03/11/2021
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