Provider Demographics
NPI:1528654928
Name:CHAVEZ, AMBER JANE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:JANE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11925 ORYX PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7222
Mailing Address - Country:US
Mailing Address - Phone:505-659-6007
Mailing Address - Fax:
Practice Address - Street 1:201 CEDAR ST SE STE 4620
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4922
Practice Address - Country:US
Practice Address - Phone:505-563-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPC000002881835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist