MEDICARE: CHIKODILI CATHERINE UBA

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
1	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	896103	TX

General Provider Information

NPI Number	:	1811700180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIKODILI CATHERINE UBA

Provider Business Mailing Address
First Line	:	21289 S 187TH WAY
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-3668
Country	:	US
Telephone Number	:	832-513-5993
Fax Number	:

Provider Business Practice Location Address
First Line	:	6428 S 23RD AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-5357
Country	:	US
Telephone Number	:	832-513-5993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2025
Last Update Date	:	06/19/2025

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Directions to “ CHIKODILI CATHERINE UBA ” Practice Location

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