Individual
MARYANNE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 S 9TH ST, BELEN, NM 87002-3102
(505) 861-1013
Mailing address
120 S 9TH ST, BELEN, NM 87002-3102
(505) 861-1013
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02694
NM
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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