Provider Demographics
NPI:1851254866
Name:TAFOYA, NOAH BAILEY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:BAILEY
Last Name:TAFOYA
Suffix:
Gender:M
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 DR MARTIN LUTHER KING JR AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3619
Mailing Address - Country:US
Mailing Address - Phone:505-803-3800
Mailing Address - Fax:
Practice Address - Street 1:601 DR MARTIN LUTHER KING JR AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3619
Practice Address - Country:US
Practice Address - Phone:505-803-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNDP-2025-0223133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered