Organization
TAOS MUNICIPAL SCHOOLS SCHOOL BASED HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA T CHAVEZ, MEDINA RN (HEALTH SERVICES, SBHC COORDINATOR)
(505) 751-8032
Entity
Organization
Contact information
Practice address
134 CERVANTES ST, TAOS, NM 87571-6163
(505) 751-8032
(505) 751-8008
Mailing address
213 PASEO DEL CANON E, TAOS, NM 87571-6239
(505) 751-8032
(505) 751-8008
Taxonomy
Speciality
Code
Description
License number
State
363LS0200X
School Nurse Practitioner
Primary
CL00010194
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q1853
—
NM
Enumeration date
01/12/2007
Last updated
08/22/2020
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