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General NPI Number Information
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NPI Number | 1295344422
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Entity Type | Individual
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Provider Name | CHEKESHA R STALEY APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 14015 MONTAIGNE DR
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City | CYPRESS
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State | TX
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Zip | 77429-2567
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Country | US
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Telephone | 973-440-5319
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Fax |
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Provider Business Mailing Address
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Address Line | 615 S HOLYOKE ST
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City | WICHITA
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State | KS
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Zip | 67218-1904
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Country | US
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Telephone |
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 53-79639-092
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 13-131530-092
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1095562
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 53-79639-092
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License Number State | KS
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1095562
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License Number State | TX
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