Individual
KEELY JUSTICE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
01 SAGEBRUSH ST., ISLETA, NM 87022
(505) 869-3200
(505) 869-4881
Mailing address
PO BOX 640, ISLETA, NM 87022-0640
(505) 869-3200
(505) 869-4881
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
R65912
NY
Other
Enumeration date
11/18/2017
Last updated
11/18/2017
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