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NPI Code Detail

MEDICARE: PATRICIA ANN CHENEY NURSE PRACTITIONER

MEDICARE:   PATRICIA ANN CHENEY  NURSE PRACTITIONER
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 Practitioner9269CA

General Provider Information

NPI Number : 1699776963
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA ANN CHENEY NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 24372 DEL AMO RD
Second Line :
City : RAMONA
State : CA
Zip : 92065-4006
Country : US
Telephone Number : 760-789-5931
Fax Number :
Provider Business Practice Location Address
First Line : 5555 GROSSMONT CENTER DR
Second Line :
City : LA MESA
State : CA
Zip : 91942-3019
Country : US
Telephone Number : 619-644-4160
Fax Number : 619-644-4380
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 07/08/2007

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Directions to “ PATRICIA ANN CHENEY NURSE PRACTITIONER” Practice Location

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