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Organization

CHEVANNES CLINIC SOLUTIONS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELLA DIONNE CLARKE NURSE PRACTITIONER (NURSE PRACTITIONER/OWNER)
(505) 258-4867
Entity
Organization

Contact information

Practice address
817 W BROADWAY STE A, FARMINGTON, NM 87401-5699
(505) 258-4867
(505) 398-8748
Mailing address
817 W BROADWAY STE A, FARMINGTON, NM 87401-5699
(505) 258-4867
(505) 398-8748

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
363LF0000X
Family Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
12870277
NM
01
1851839740
NPI
NM
Enumeration date
10/14/2024
Last updated
10/30/2024
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