Provider Demographics
NPI:1285903328
Name:SANCHEZ, SARA MARIE (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:MARIE
Last Name:SANCHEZ
Suffix:
Gender:
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:RADIUM SPRINGS
Mailing Address - State:NM
Mailing Address - Zip Code:88054-0308
Mailing Address - Country:US
Mailing Address - Phone:575-571-9008
Mailing Address - Fax:575-993-5108
Practice Address - Street 1:715 E IDAHO AVE STE 3A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-4702
Practice Address - Country:US
Practice Address - Phone:575-571-9008
Practice Address - Fax:575-993-5108
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM11092R176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM98151541Medicaid