Individual
JENNIFER ELLEN CHITTUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 7TH ST, LAS VEGAS, NM 87701-3993
(505) 425-3566
Mailing address
501 7TH ST, LAS VEGAS, NM 87701-3993
(505) 425-3566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD2009-0114
NM
208000000X
Pediatrics Physician
N3561
TX
Other
Enumeration date
12/17/2007
Last updated
02/21/2012
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