Jennifer Ellen Chittum, MD | |
501 7th St, Las Vegas, NM 87701-3993 | |
(505) 425-3566 | |
Not Available |
Full Name | Jennifer Ellen Chittum |
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Gender | Female |
Speciality | Pediatrics |
Location | 501 7th St, Las Vegas, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1083898712 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD2009-0114 (New Mexico) | Primary |
208000000X | Pediatrics | N3561 (Texas) | Secondary |
Entity Name | St. Vincent Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578587150 PECOS PAC ID: 6608775135 Enrollment ID: O20040105000372 |
Mailing Address | Practice Location Address |
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Jennifer Ellen Chittum, MD 501 7th St, Las Vegas, NM 87701-3993 Ph: (505) 425-3566 | Jennifer Ellen Chittum, MD 501 7th St, Las Vegas, NM 87701-3993 Ph: (505) 425-3566 |
Dr. Nancy Jane Wright, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 501 Seventh Street, Las Vegas Clinic For Children & Youth, Las Vegas, NM 87701 Phone: 505-425-3566 Fax: 505-425-3568 | |
Mary Starr Schipper, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: Las Vegas Clinic For Children & Youth, 501 7th Street, Las Vegas, NM 87701 Phone: 505-425-3566 Fax: 505-425-3568 |