Individual
MS. RIFKA MADRONA BOURDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LM
Contact information
Practice address
318 PASEO DEL NORTE # 1624, TAOS, NM 87571-9066
(575) 779-7571
Mailing address
PO BOX 1624, TAOS, NM 87571-1624
(575) 779-7571
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
09067R
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140157
OREGON PROVIDER #
OR
Enumeration date
07/24/2006
Last updated
01/31/2014
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