Provider Demographics
NPI:1831705094
Name:GARCIA, RACHEL LEANNE (CNM)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LEANNE
Last Name:GARCIA
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 1:2032 BARONA AVE SE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-8861
Mailing Address - Country:US
Mailing Address - Phone:505-688-9509
Mailing Address - Fax:
Practice Address - Street 1:4701 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1219
Practice Address - Country:US
Practice Address - Phone:505-727-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM791176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMCNM06379OtherAMCB CERTIFICAITON
NMRN-70089OtherNM RN LICENSE
NMCS00229288OtherNM BOP CSL
NM791OtherNM DEPARTMENT OF HEALTH CNM LICENSE