Connie L Koshewa, L.M, C.P.M
Individual provider Active NPI Midwife · Albuquerque, NM
NPI 1487710596 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1487710596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Midwife 176B00000X
- License
- 04008R (NM)
- Practice address
- 123 Wellesley Dr SE
Albuquerque, NM 87106-1443 - Phone
- (505) 266-5762
- Fax
- (505) 268-7500
- NPI assigned
- Jan 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 04008R | NM | MD | Midwife |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 04008R | NM | Yes |
Addresses
Primary practice location
123 Wellesley Dr SE
Albuquerque, NM 87106-1443
Mailing address
21 Garden Park Cir NW
Albuquerque, NM 87107-2655
Phone (505) 293-1147
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 97423882 | Medicaid | NM |
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.