Provider Demographics
NPI:1588983472
Name:ALUMBRA WOMEN'S HEALTH AND MATERNITY CARE
Entity type:Organization
Organization Name:ALUMBRA WOMEN'S HEALTH AND MATERNITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE-MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-718-8100
Mailing Address - Street 1:555 N LUNA DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-9779
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-3481
Practice Address - Country:US
Practice Address - Phone:505-718-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty