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Individual
MRS. BRENDA J CHAVEZ
Active
Individual
MRS. BRENDA J CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
45082
KS
363L00000X
Nurse Practitioner
Primary
45082
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100405970H
—
KS
01
—
161992
MEDICARE
KS
Enumeration date
06/16/2005
Last updated
10/13/2023
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