Individual
KATHY REBECCA FRESQUEZ-CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.F.N.P.
Contact information
Practice address
328 MAIN ST NE, LOS LUNAS, NM 87031-7454
(505) 916-5167
(505) 916-5170
Mailing address
PO BOX 486, LOS LUNAS, NM 87031-0486
(505) 916-5167
(505) 916-5170
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R37352
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84304235
—
NM
Enumeration date
08/01/2006
Last updated
05/23/2013
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