Individual
STACIE S CHAMBLESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
920 W BROADWAY ST, HOBBS, NM 88240-5529
(575) 393-3168
(575) 397-4659
Mailing address
920 W BROADWAY ST, HOBBS, NM 88240-5529
(575) 393-3168
(575) 397-4659
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L14937
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463000
—
NM
Enumeration date
01/30/2009
Last updated
01/30/2009
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