Healthcare Provider Details

I. General information

NPI: 1316896202
Provider Name (Legal Business Name): MELISSA E CHAVEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2026
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7324 NAGOYA RD NE
RIO RANCHO NM
87144-3530
US

IV. Provider business mailing address

7324 NAGOYA RD NE
RIO RANCHO NM
87144-3530
US

V. Phone/Fax

Practice location:
  • Phone: 505-440-3037
  • Fax:
Mailing address:
  • Phone: 505-440-3037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4138245
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: