MEDICARE: ANNETTE CHAVEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	R42519	NM

General Provider Information

NPI Number	:	1063376036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNETTE CHAVEZ

Provider Business Mailing Address
First Line	:	703 FRED CT
Second Line	:
City	:	BELEN
State	:	NM
Zip	:	87002-4700
Country	:	US
Telephone Number	:	505-382-8523
Fax Number	:	505-433-3219

Provider Business Practice Location Address
First Line	:	3080 DESERT SAGE AVE SW
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-6577
Country	:	US
Telephone Number	:	505-804-2899
Fax Number	:	505-433-3219

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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Directions to “ ANNETTE CHAVEZ ” Practice Location

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