Chatelain, Manda Louise

Chatelain, Manda Louise is an individual health care provider with primary practice located at 1331 N 7Th St Ste 405 , Phoenix AZ 85006-2754. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Chatelain, Manda Louise can be contacted via phone (602) 254-3151.

Contact Information

Primary practice address
1331 N 7Th St Ste 405 Phoenix AZ 85006-2754
Phone: (602) 254-3151
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X AP1568 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP1568 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP1568 Arizona

Profile Details

NPI number 1124049838
LBN Legal business name Chatelain, Manda Louise
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Feb 13th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124049838 NPPES
Arizona Other 860224285 TAX ID
Arizona Other 188316200 TAX ID
Arizona Other 1Z9797 TAX ID
Arizona Other CD4863 TAX ID
Arizona MEDICAID 751679 TAX ID
Arizona Other AZ0143190 TAX ID

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