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General NPI Number Information
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NPI Number | 1093238651
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Entity Type | Individual
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Provider Name | KAYLEENA JEANINE- TEJADA CHENTFANT FNP
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Gender | Female
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 2033 E WARNER RD SUITE 109
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City | TEMPE
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State | AZ
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Zip | 85284-3417
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Country | US
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Telephone | 480-820-5525
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Fax | 480-831-6755
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Provider Business Mailing Address
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Address Line | 7353 W MILTON DR
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City | PEORIA
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State | AZ
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Zip | 85383-5314
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Country | US
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Telephone | 480-820-5525
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Fax | 480-831-6755
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP10384
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License Number State | AZ
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