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Individual

NICOLE M CHAVEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1234
Mailing address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930

Taxonomy

Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
1059
NM
133VN1005X
Renal Nutrition Registered Dietitian
1059
NM
133VN1401X
Pediatric Critical Care Nutrition Registered Dietitian
1059
NM

Other

Enumeration date
04/29/2024
Last updated
04/29/2024
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