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Individual

MS. CHLOE ANNALEWISE PACHECO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
7001 SIGNAL AVE NE, ALBUQUERQUE, NM 87113-2453
(505) 856-2735
(505) 856-2749
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71065
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6F2981
MEDICARE PTAN
NM
05
73521272
NM
Enumeration date
01/02/2023
Last updated
02/23/2024
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