Individual
MRS. KIM RALEIGH PRAIRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
101 HOSPITAL LOOP NE STE 105, ALBUQUERQUE, NM 87109-2100
(505) 843-6168
(505) 792-1978
Mailing address
6320 RIVERSIDE PLAZA LN NW STE B, ALBUQUERQUE, NM 87120-1710
(505) 843-6168
(505) 792-1978
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R35843
NM
367A00000X
Advanced Practice Midwife
Primary
578
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35987359
—
NM
Enumeration date
04/07/2009
Last updated
07/21/2020
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