Provider Demographics
NPI:1639397086
Name:MONTIEL, MARIA ANDREA (CNM)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANDREA
Last Name:MONTIEL
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 1:201 CEDAR ST SE
Mailing Address - Street 2:STE. 5640
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4917
Mailing Address - Country:US
Mailing Address - Phone:505-843-6168
Mailing Address - Fax:505-247-9743
Practice Address - Street 1:6320 RIVERSIDE PLAZA LN NW
Practice Address - Street 2:STE. A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1710
Practice Address - Country:US
Practice Address - Phone:505-843-6168
Practice Address - Fax:505-890-5933
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM548176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM91585554Medicaid
NM91585554Medicaid