Individual
AMANDA ROSE CHEETHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 S DOBSON RD STE 202, MESA, AZ 85202-4724
(866) 974-2673
Mailing address
18444 N 25TH AVE STE 310, PHOENIX, AZ 85023-1266
(866) 974-2673
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
9549
AZ
363A00000X
Physician Assistant
Primary
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
08/13/2025
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