Provider Demographics
NPI:1568855419
Name:QUIGLEY-TREJO, KAREN (LM, IBCLC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:QUIGLEY-TREJO
Suffix:
Gender:F
Credentials:LM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MARQUETTE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-1935
Mailing Address - Country:US
Mailing Address - Phone:505-459-1901
Mailing Address - Fax:866-730-6883
Practice Address - Street 1:901 MARQUETTE AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-1935
Practice Address - Country:US
Practice Address - Phone:505-459-1901
Practice Address - Fax:877-500-7949
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM15136-R175M00000X
NM11127253174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175M00000XOther Service ProvidersMidwife, Lay