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Individual

MRS. BETHANY DEREA CHEATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
4425 E AGAVE RD, #148, PHOENIX, AZ 85044-0619
(480) 704-7546
Mailing address
4425 E AGAVE RD, #148, PHOENIX, AZ 85044-0619
(480) 704-7546

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F1114254
AZ

Other

Enumeration date
11/17/2014
Last updated
09/19/2016
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