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General NPI Number Information
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NPI Number | 1063376036
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Entity Type | Individual
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Provider Name | ANNETTE CHAVEZ
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Gender | Female
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 3080 DESERT SAGE AVE SW
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City | LOS LUNAS
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State | NM
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Zip | 87031-6577
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Country | US
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Telephone | 505-804-2899
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Fax | 505-433-3219
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Provider Business Mailing Address
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Address Line | 703 FRED CT
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City | BELEN
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State | NM
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Zip | 87002-4700
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Country | US
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Telephone | 505-382-8523
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Fax | 505-433-3219
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R42519
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License Number State | NM
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