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Individual

MRS. NICHOLE ANN CHAVEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
5340 N. WIGWAM CREEK BLVD, LITCHFIELD PARK, AZ 85340-4930
(623) 547-1418
Mailing address
19740 W HILTON AVE, BUCKEYE, AZ 85326-9034
(623) 547-1418

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP045089
AZ

Other

Enumeration date
04/16/2013
Last updated
04/16/2013
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