Individual
ALISA HENNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
7708 4TH ST NW, LOS RANCHOS, NM 87107
(505) 924-2229
(505) 554-3673
Mailing address
7708 4TH ST NW, LOS RANCHOS, NM 87107-6510
(505) 924-2229
(505) 554-3673
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
746
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831304377
—
NC
Enumeration date
05/10/2007
Last updated
10/01/2021
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