Provider Demographics
NPI:1306904404
Name:PEPPER, BARBARA ELLEN (LICENSED MIDWIFE)
Entity type:Individual
Prefix:MISS
First Name:BARBARA
Middle Name:ELLEN
Last Name:PEPPER
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6626
Mailing Address - Country:US
Mailing Address - Phone:505-255-9545
Mailing Address - Fax:505-255-9545
Practice Address - Street 1:7320 4TH ST NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6626
Practice Address - Country:US
Practice Address - Phone:505-255-9545
Practice Address - Fax:505-255-9545
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM82060R175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM94227Medicaid