National Provider Identifier Database

CHEVANNES CLINIC SOLUTIONS LLC
Family


Contact Information

CHEVANNES CLINIC SOLUTIONS, LLC
817 W BROADWAY STE A
FARMINGTON, NM87401-5699
Phone: 505-258-4867
Fax: 505-398-8748
Website:
Specialty Taxonomy Code
* Family 363LF0000X
Family Medicine 207Q00000X

* Indicates primary specialty

NPI Profile & details for CHEVANNES CLINIC SOLUTIONS, LLC

NPI Number 1013737261
Legal business name
LBN
CHEVANNES CLINIC SOLUTIONS, LLC
Authorized official ANGELLA CLARKE - (NURSE PRACTITIONER/OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/14/2024
Last updated 10/30/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • NM Medicaid: 12870277
  • NM Other: 1851839740 NPI

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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