Individual
LADONNA LEE CHACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
402 E MIEL DE LUNA AVE, TUCUMCARI, NM 88401-3828
(575) 461-7100
(575) 461-7101
Mailing address
402 E MIEL DE LUNA AVE, TUCUMCARI, NM 88401-3828
(575) 461-7100
(575) 461-7101
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R32046
NM
363LA2200X
Adult Health Nurse Practitioner
CNP-02602
NM
363LG0600X
Gerontology Nurse Practitioner
CNP-02602
NM
363LP2300X
Primary Care Nurse Practitioner
Primary
CNP-02602
NM
Other
Enumeration date
10/04/2014
Last updated
11/20/2024
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