Individual
VICKY CHAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN CWCA CLT
Contact information
Practice address
4494 W PEORIA AVE STE 115A, GLENDALE, AZ 85302-2020
(314) 440-7583
Mailing address
6968 W PALO VERDE DR, GLENDALE, AZ 85303-4405
(314) 440-7583
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP053821
AZ
Other
Enumeration date
10/07/2021
Last updated
06/06/2025
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