Provider Demographics
NPI:1215950191
Name:STETSON, VICTORIA L (CNM)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:STETSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:STETSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27829
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125
Mailing Address - Country:US
Mailing Address - Phone:505-232-1920
Mailing Address - Fax:505-727-9276
Practice Address - Street 1:5150 JOURNAL CENTER BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-254-6500
Practice Address - Fax:505-254-6532
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM308176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM98514Medicaid
NM98514Medicaid
P96267Medicare UPIN