Active NPI
Jeanne Malchow, CNM/FNP
- Obstetrics & Gynecology Nurse Practitioner
- Los Alamos, NM
National Provider Identifier
1104017532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- R29819
- Practice address
- 3917 West Rd
Suite 250
Los Alamos, NM 87544-2275 - Phone
- (505) 662-4412
- Fax
- (505) 661-6536
- NPI assigned
- Aug 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | R29819 | NM | Primary |
Addresses
Primary practice location
3917 West Rd
Suite 250
Los Alamos, NM 87544-2275
Mailing address
3917 West Rd
Suite 250
Los Alamos, NM 87544-2275
Phone (505) 662-4412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R29819 | NM | MD | Obstetrics & Gynecology Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186617600000",
"number": "1104017532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3917 WEST RD",
"address_2": "SUITE 250",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875442275",
"telephone_number": "505-662-4412",
"fax_number": "505-661-6536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3917 WEST RD",
"address_2": "SUITE 250",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875442275",
"telephone_number": "505-662-4412",
"fax_number": "505-661-6536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALCHOW",
"first_name": "JEANNE",
"name_prefix": "Miss",
"credential": "CNM/FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-09",
"last_updated": "2007-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "NM",
"license": "R29819",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Alamos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.