Healthcare Provider Details

I. General information

NPI: 1467388520
Provider Name (Legal Business Name): SAVAGE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 S MAIN ST
LAS CRUCES NM
88001-1270
US

IV. Provider business mailing address

125 S MAIN ST
LAS CRUCES NM
88001-1270
US

V. Phone/Fax

Practice location:
  • Phone: 575-294-2597
  • Fax:
Mailing address:
  • Phone: 575-294-2597
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHANTAL SAVAGE
Title or Position: CEO
Credential: DNP FNP-BC
Phone: 575-294-2597