Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 5901002337 | MI |
N | 222Z00000X | Podiatrist | 5901002337 | MI |
Y | 213ES0103X | Foot & Ankle Surgery | 342 | NM |
N | 213ES0103X | Foot & Ankle Surgery | 5901002337 | MI |
N | 213ES0131X | Foot Surgery | 5901002337 | MI |
NPI | 1073743704 |
---|---|
Provider Name | Yolanda J Chacon |
First Address | Las Cruces, NM 88011-8616 |
Second Address | Las Cruces, NM 88011-8616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 27/08/2012 |