Healthcare Provider Details

I. General information

NPI: 1801573696
Provider Name (Legal Business Name): CHLOE NORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/03/2023
Certification Date: 07/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 RIO GRANDE BLVD NW STE H160
ALBUQUERQUE NM
87104-2063
US

IV. Provider business mailing address

706 FRUIT AVE NW APT H
ALBUQUERQUE NM
87102-2086
US

V. Phone/Fax

Practice location:
  • Phone: 505-278-0807
  • Fax:
Mailing address:
  • Phone: 503-930-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: