Provider Demographics
NPI:1023041035
Name:AKINS, SUSAN M (CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:AKINS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 MAESTAS RD
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6268
Mailing Address - Country:US
Mailing Address - Phone:575-758-5001
Mailing Address - Fax:575-737-5046
Practice Address - Street 1:1331 MAESTAS RD
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6268
Practice Address - Country:US
Practice Address - Phone:575-758-5001
Practice Address - Fax:575-737-5046
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR63738163W00000X
NM568176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120082604Medicaid
TX120082604Medicaid