Provider Demographics
NPI:1427638113
Name:REBECCA PALAK MIDWIFERY
Entity type:Organization
Organization Name:REBECCA PALAK MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:505-660-0140
Mailing Address - Street 1:2387 CAMINO PINTORES
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-5290
Mailing Address - Country:US
Mailing Address - Phone:505-660-0140
Mailing Address - Fax:
Practice Address - Street 1:2387 CAMINO PINTORES
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-5290
Practice Address - Country:US
Practice Address - Phone:505-660-0140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-08
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175M00000XOther Service ProvidersMidwife, LayGroup - Single Specialty