Provider Demographics
NPI:1215953302
Name:LEVI, AMY JO (CNM)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:LEVI
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:933 BRADBURY DR SE
Mailing Address - Street 2:SUITE 2222
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4374
Mailing Address - Country:US
Mailing Address - Phone:505-272-3120
Mailing Address - Fax:505-272-0860
Practice Address - Street 1:MSC 09 5350
Practice Address - Street 2:1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-0864
Practice Address - Fax:505-272-8901
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-12-14
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Provider Licenses
StateLicense IDTaxonomies
NM02088363LW0102X
NM640367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW016860Medicaid
S15609Medicare UPIN
CANMW016860Medicaid