Mattke, Lisa L

Mattke, Lisa L is an individual health care provider with primary practice located at 201 Cedar St Se Ste. 5640, Albuquerque NM 87106-4917. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Midwife, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Mattke, Lisa L can be contacted via phone (505) 843-6168.

Contact Information

Primary practice address
201 Cedar St Se Ste. 5640 Albuquerque NM 87106-4917
Phone: (505) 843-6168
Fax: (505) 247-9743
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Midwife 176B00000X R148101-3 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 620 New Mexico

Profile Details

NPI number 1790754737
LBN Legal business name Mattke, Lisa L
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Aug 20th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790754737 NPPES
New Mexico MEDICAID 86807331

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