Individual
MRS. JACKLYN CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
201 CEDAR ST SE STE 304, ALBUQUERQUE, NM 87106-4932
(505) 843-7813
(505) 843-6947
Mailing address
201 CEDAR ST SE STE 304, ALBUQUERQUE, NM 87106-4932
(505) 843-7813
(505) 843-6947
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2015-0091
NM
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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