Healthcare Provider Details

I. General information

NPI: 1285321232
Provider Name (Legal Business Name): CHEYANNE HULS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 06/07/2024
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 836 BOX 2670
FPO AE
09636-9998
US

IV. Provider business mailing address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2111
US

V. Phone/Fax

Practice location:
  • Phone: 314-624-3842
  • Fax:
Mailing address:
  • Phone: 757-953-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number161620
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: