Individual
STACEY CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
105 REDWING, CLOVIS, NM 88101-9597
(575) 309-7237
Mailing address
105 REDWING, CLOVIS, NM 88101-9597
(575) 309-7237
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
57003
NM
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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