Keely Justice Chavez, RN
Individual provider Active NPI Diabetes Educator Registered Nurse · Isleta, NM
NPI 1073027629 · NPPES record last updated Nov 18, 2017
Key facts
- NPI
- 1073027629
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diabetes Educator Registered Nurse 163WD0400X
- License
- R65912 (NY)
- Practice address
- 01 Sagebrush St.
Isleta, NM 87022 - Phone
- (505) 869-3200
- Fax
- (505) 869-4881
- NPI assigned
- Nov 18, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R65912 | NY | MD | Diabetes Educator Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse | 163WD0400X | R65912 | NY | Yes |
Addresses
Primary practice location
01 Sagebrush St.
Isleta, NM 87022
Mailing address
PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-3200
Other providers in Isleta, NM
- Stephanie Ruth Barela
- Attlee Becenti Benally
- Erica Leanne Carrasco
- Erica Marie Carrillo
- Kaylee Briana Chavez
- Misti Marlene Chavez
- Lisa K Cherino
- Susan Stephanie Chewiwi
- Jessica Chynoweth
- Kimberly L. Conklan
All providers in Isleta, NM · Diabetes Educator Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.