Individual
AMANDA IRIS CHACONAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1016 W UNIVERSITY AVE STE 206, FLAGSTAFF, AZ 86001-2996
(928) 226-1530
Mailing address
1016 W UNIVERSITY AVE STE 206, FLAGSTAFF, AZ 86001-2996
(928) 226-1530
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN172540
AZ
363LG0600X
Gerontology Nurse Practitioner
Primary
TEMP281408
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467701664
—
AZ
Enumeration date
09/04/2012
Last updated
07/10/2023
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