Individual
AMANDA ROSE CHEETHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2940 E BANNER GATEWAY DR STE 200-250, GILBERT, AZ 85234-2168
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
9549
AZ
363A00000X
Physician Assistant
Primary
9549
AZ
363AS0400X
Surgical Physician Assistant
9549
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148489
—
AZ
Enumeration date
02/23/2021
Last updated
07/23/2026
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