Provider Demographics
NPI:1811503303
Name:CHAVARRIA, MEGAN DEANNE (NP CNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:DEANNE
Last Name:CHAVARRIA
Suffix:
Gender:F
Credentials:NP CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 W CANTERBURY ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88242-9749
Mailing Address - Country:US
Mailing Address - Phone:575-942-1094
Mailing Address - Fax:
Practice Address - Street 1:200 W LEA ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5110
Practice Address - Country:US
Practice Address - Phone:575-391-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM61130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily