MEDICARE: JULIUS E CHANEY NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN033784	AZ
2	363LF0000X	Family Nurse Practitioner	AP0111	AZ

General Provider Information

NPI Number	:	1851394183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIUS E CHANEY NP-C

Provider Business Mailing Address
First Line	:	3620 N 3RD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2020
Country	:	US
Telephone Number	:	602-230-7373
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 E THUNDERBIRD RD STE 1-3
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-5306
Country	:	US
Telephone Number	:	602-230-7373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/30/2020

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