Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | AP2349 | AZ |
N | 363L00000X | Nurse Practitioner | AP2349 | AZ |
NPI | 1043313646 |
---|---|
Provider Name | Mrs. Rukiya J Chavers |
First Address | Phoenix, AZ 85037-5772 |
Second Address | Phoenix, AZ 85037-5772 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 28/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
235248 | (05) | AZ |