Healthcare Provider Details

I. General information

NPI: 1649768953
Provider Name (Legal Business Name): CHIKAODI PRISCILLA BANOR DNP,PMHHP-BC,FNP-C,A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2018
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 W RAY RD SUITE 4
CHANDLER AZ
85225-7284
US

IV. Provider business mailing address

501 W RAY RD STE 4
CHANDLER AZ
85225-7284
US

V. Phone/Fax

Practice location:
  • Phone: 480-590-5146
  • Fax: 480-590-6120
Mailing address:
  • Phone: 480-590-5146
  • Fax: 480-590-6120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11330
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61655857
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP137355
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: