Individual
LISA L MATTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
201 CEDAR ST SE, STE. 5640, ALBUQUERQUE, NM 87106-4917
(505) 843-6168
(505) 247-9743
Mailing address
201 CEDAR ST SE, STE. 5640, ALBUQUERQUE, NM 87106-4917
(505) 843-6168
(505) 247-9743
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
R148101-3
MN
367A00000X
Advanced Practice Midwife
41345
TN
367A00000X
Advanced Practice Midwife
Primary
620
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
86807331
—
NM
Enumeration date
03/14/2006
Last updated
04/15/2026
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