Provider Demographics
NPI:1396122776
Name:SACRED PASSAGE MIDWIFERY
Entity type:Organization
Organization Name:SACRED PASSAGE MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOCHET
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:575-770-5253
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-1092
Mailing Address - Country:US
Mailing Address - Phone:575-770-5253
Mailing Address - Fax:
Practice Address - Street 1:245 TUNE DRIVE
Practice Address - Street 2:
Practice Address - City:EL PRADO
Practice Address - State:NM
Practice Address - Zip Code:87529-1092
Practice Address - Country:US
Practice Address - Phone:575-770-5253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-05
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM96367R175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Single Specialty