Provider Demographics
NPI:1295915346
Name:NATURAL WOMENS HEALTH LLC
Entity type:Organization
Organization Name:NATURAL WOMENS HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEILER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:505-433-2755
Mailing Address - Street 1:4550 EUBANK BLVD NE
Mailing Address - Street 2:STE 105
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2565
Mailing Address - Country:US
Mailing Address - Phone:505-296-1120
Mailing Address - Fax:505-296-0718
Practice Address - Street 1:4550 EUBANK BLVD NE
Practice Address - Street 2:STE 105
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3479
Practice Address - Country:US
Practice Address - Phone:505-296-1120
Practice Address - Fax:505-296-0718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR17788261QP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM363L00000XMedicaid
800521034Medicare PIN
NM585689403RMedicare PIN
NM800521034Medicare Oscar/Certification
NMS47909Medicare UPIN