Provider Demographics
NPI:1790184307
Name:LOVING, CHIQUITA LYNETTE A
Entity Type:Individual
Prefix:DR
First Name:CHIQUITA
Middle Name:LYNETTE A
Last Name:LOVING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHIQUITA
Other - Middle Name:LYNETTE A
Other - Last Name:LOVING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3011 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NEW MEXICO
Mailing Address - Zip Code:88001
Mailing Address - Country:UM
Mailing Address - Phone:575-647-8878
Mailing Address - Fax:
Practice Address - Street 1:3011 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1164
Practice Address - Country:US
Practice Address - Phone:575-647-8878
Practice Address - Fax:575-647-8252
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMRP00007792OtherPHARMACIST