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General NPI Number Information
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NPI Number | 1548224033
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Entity Type | Individual
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Provider Name | MADELINE K CHALENOR CRNA, DNP
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Gender | Female
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 42121 US HIGHWAY 70
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City | PORTALES
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State | NM
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Zip | 88130
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Country | US
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Telephone | 575-359-1800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 208050
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City | DALLAS
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State | TX
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Zip | 75320-8050
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Country | US
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Telephone |
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Fax |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 111316
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA00553
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License Number State | NM
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