| Doctor Name: | MISS JEANNE MALCHOW |
| NPI Number: | 1104017532 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNM/FNP |
| License Number: | R29819 |
| Business Practice Address: | 3917 West Rd Suite 250 Los Alamos, NM - 875442275 |
| Business Phone Number: | 5056624412 |
| Business Fax Number: | 5056616536 |
| Mailing Address: | 3917 West Rd, Suite 250 LOS ALAMOS |
| State: | NM |
| Postal Code: | 875442275 |
| Phone Number: | 5056624412 |
| Fax Number: | 5056616536 |
| NPI Enumeration Date: | 08/09/2007 |
| NPI Last Update Date: | 08/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LX0001X |
| License Number: | R29819 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Obstetrics & Gynecology |
| Taxonomy Definition: | |