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Contact Information

SANTA FE FAMILY AND FUNCTIONAL MEDICINE PC
401 BOTULPH LANE
SANTA FE, NM87505
 Phone: 505-983-8387
 Fax: 505-820-2733
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for SANTA FE FAMILY AND FUNCTIONAL MEDICINE PC · (Female)

NPI # 1255400040
Status Active
Credentials
Entity Individual
Enumeration date 11/07/2006
Last updated 07/13/2017 - About 9 years ago
Sole proprietor 1 Not specified
Identifiers
  • NM Medicaid 49064
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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