Provider Demographics
NPI:1548801400
Name:MAYES, CASANDRA ANNE (CNM)
Entity Type:Individual
Prefix:
First Name:CASANDRA
Middle Name:ANNE
Last Name:MAYES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:CASANDRA
Other - Middle Name:ANNE
Other - Last Name:CROWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:914 AZTEC RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-2534
Mailing Address - Country:US
Mailing Address - Phone:505-409-8146
Mailing Address - Fax:
Practice Address - Street 1:1500 WALTER ST SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-4658
Practice Address - Country:US
Practice Address - Phone:505-272-2156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM776176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife