Healthcare Provider Details

I. General information

NPI: 1811503303
Provider Name (Legal Business Name): MEGAN DEANNE CHAVARRIA NP CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2020
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W LEA ST
HOBBS NM
88240-5110
US

IV. Provider business mailing address

1225 W CANTERBURY ST
HOBBS NM
88242-9749
US

V. Phone/Fax

Practice location:
  • Phone: 575-391-0270
  • Fax:
Mailing address:
  • Phone: 575-942-1094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61130
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: