Healthcare Provider Details

I. General information

NPI: 1336074210
Provider Name (Legal Business Name): CHEYENNE GUNSALUS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 E BASELINE RD STE 400
GILBERT AZ
85234-2472
US

IV. Provider business mailing address

6961 E HAMPTON AVE APT 3105
MESA AZ
85209-3352
US

V. Phone/Fax

Practice location:
  • Phone: 480-494-5357
  • Fax:
Mailing address:
  • Phone: 440-381-9021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number479631
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: