Nicole M Chavez, RN, BSN
Individual provider Active NPI School Registered Nurse · Grants, NM
NPI 1619674041 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1619674041
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- RN-85963 (NM)
- Practice address
- 413 Roosevelt Ave
Grants, NM 87020 - Phone
- (505) 240-0877
- NPI assigned
- Feb 15, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN-85963 | NM | MD | School Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy 4 Health Solutions, LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | RN-85963 | NM | Yes |
Addresses
Primary practice location
413 Roosevelt Ave
Grants, NM 87020
Mailing address
PO Box 8
Grants, NM 87020-0008
Phone (505) 240-0877
Other providers in Grants, NM
- Charity Ann Casias
- Shanise Castaneda
- Celestee Cathey
- Catholic Charities of Gallup
- Mercedes Romo Chavez
- Shannon Chavez
- Christy E Cheromiah
- Ann K Church
- Cibola General Hospital Corporation
- Cibola General Hospital Corporation
All providers in Grants, NM · School 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 Feb 15, 2023. 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.