Individual
SHANNON GRACE CHITTENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
115 E WILLIAMS FIELD RD STE 101, GILBERT, AZ 85295-5231
(480) 270-8318
Mailing address
115 E WILLIAMS FIELD RD STE 101, GILBERT, AZ 85295-5231
(515) 360-9127
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
235623
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
235623
ARIZONA BOARD OF NURSING
AZ
Enumeration date
12/11/2020
Last updated
03/07/2023
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