Lisa C. Pena, CPM, LM
Individual provider Active NPI Midwife · Mesilla, NM
NPI 1477165629 · NPPES record last updated Aug 19, 2020
Key facts
- NPI
- 1477165629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 20005R (NM)
- Practice address
- 2110 Calle de San Albino
Mesilla, NM 88046-8804 - Phone
- (575) 496-5042
- NPI assigned
- Aug 19, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20005R | NM | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 20005R | NM | Yes |
Addresses
Primary practice location
2110 Calle de San Albino
Mesilla, NM 88046-8804
Mailing address
PO Box 1042
Mesilla, NM 88046-1042
Phone (575) 496-5042
Other providers in Mesilla, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.