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General NPI Number Information
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NPI Number | 1588792378
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Entity Type | Individual
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Provider Name | KANDY LEIGH CHINTIS RN
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 NORTH 1ST AVE
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City | WHITERIVER
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State | AZ
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Zip | 85941
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Country | US
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Telephone | 928-338-4138
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Fax | 928-338-6130
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Provider Business Mailing Address
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Address Line | 5339 BRANDING IRON LOOP
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City | PINETOP
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State | AZ
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Zip | 85935-8534
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Country | US
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Telephone | 928-338-4138
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Fax | 928-338-6130
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | RN026274
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License Number State | AZ
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