MEDICARE: MELANIE HEATHER CHAVEZ FNP

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	363L00000X	Nurse Practitioner	63398	NM

General Provider Information

NPI Number	:	1881269504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE HEATHER CHAVEZ FNP

Provider Business Mailing Address
First Line	:	105 MILLS AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4169
Country	:	US
Telephone Number	:	505-431-8497
Fax Number	:	505-628-1725

Provider Business Practice Location Address
First Line	:	105 MILLS AVE STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4169
Country	:	US
Telephone Number	:	505-617-3870
Fax Number	:

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

Provider Enumeration Date	:	05/25/2021
Last Update Date	:	03/10/2026

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Directions to “ MELANIE HEATHER CHAVEZ FNP” Practice Location

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