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NPI Code Detail

MEDICARE: NICOLE CHRISMAN

MEDICARE: NICOLE CHRISMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner10002261OR
2363L00000XNurse Practitioner300419AZ

General Provider Information

NPI Number : 1669198859
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE CHRISMAN
Provider Business Mailing Address
First Line : 2201 W FAIRVIEW ST STE 9
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-4704
Country : US
Telephone Number : 480-470-4000
Fax Number :
Provider Business Practice Location Address
First Line : 2201 W FAIRVIEW ST STE 9
Second Line :
City : CHANDLER
State : AZ
Zip : 85224-4704
Country : US
Telephone Number : 480-470-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2022
Last Update Date : 02/28/2025

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Directions to “ NICOLE CHRISMAN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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