Provider Demographics
NPI:1972610343
Name:DUNCAN, AMY (CPM,LM)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:CPM,LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 E 16TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-6513
Mailing Address - Country:US
Mailing Address - Phone:505-538-5176
Mailing Address - Fax:
Practice Address - Street 1:414 E 16TH ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-6513
Practice Address - Country:US
Practice Address - Phone:505-538-5176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00399R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM006919OtherBCBS
NM31205356Medicaid