Individual
GIA CHEZVON SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
100 W CHICAGO AVE STE F, EAST CHICAGO, IN 46312-3261
(219) 392-7016
(219) 397-6904
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71015877A
IN
Other
Enumeration date
11/27/2023
Last updated
11/22/2024
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