Healthcare Provider Details

I. General information

NPI: 1831802164
Provider Name (Legal Business Name): CHLOE ANNALEWISE PACHECO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHLOE ANNALEWISE STRECKER

II. Dates (important events)

Enumeration Date: 01/02/2023
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 SIGNAL AVE NE
ALBUQUERQUE NM
87113-2453
US

IV. Provider business mailing address

PO BOX 603725
CHARLOTTE NC
28260-3725
US

V. Phone/Fax

Practice location:
  • Phone: 505-856-2735
  • Fax: 505-856-2749
Mailing address:
  • Phone: 828-575-2625
  • Fax: 828-350-2174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71065
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: