Provider Demographics
NPI:1831802164
Name:PACHECO, CHLOE ANNALEWISE (NP)
Entity type:Individual
Prefix:MS
First Name:CHLOE
Middle Name:ANNALEWISE
Last Name:PACHECO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:ANNALEWISE
Other - Last Name:STRECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 603725
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-3725
Mailing Address - Country:US
Mailing Address - Phone:828-575-2625
Mailing Address - Fax:828-350-2174
Practice Address - Street 1:7001 SIGNAL AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2453
Practice Address - Country:US
Practice Address - Phone:505-856-2735
Practice Address - Fax:505-856-2749
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM71065363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM6F2981OtherMEDICARE PTAN
NM73521272Medicaid