Healthcare Provider Details

I. General information

NPI: 1093370215
Provider Name (Legal Business Name): CIERRA NICHOLE CHEV APRN, AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 12/01/2023
Certification Date: 12/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 W MEEKER BLVD
SUN CITY WEST AZ
85375-5282
US

IV. Provider business mailing address

1510 E FLOWER ST
PHOENIX AZ
85014-5656
US

V. Phone/Fax

Practice location:
  • Phone: 623-524-4000
  • Fax:
Mailing address:
  • Phone: 602-530-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number225619
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: