MEDICARE: AUDREY L. CHUMLEY M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	057	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598874554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDREY L. CHUMLEY M.S.

Provider Business Mailing Address
First Line	:	1454 S SAINT FRANCIS DR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4038
Country	:	US
Telephone Number	:	505-988-9819
Fax Number	:

Provider Business Practice Location Address
First Line	:	1454 S SAINT FRANCIS DR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4038
Country	:	US
Telephone Number	:	505-988-9819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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