Provider Demographics
NPI:1043998628
Name:STRECKER, CAROLINE CHUNG (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CHUNG
Last Name:STRECKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5556 S INTEGRITY LN
Mailing Address - Street 2:
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86426-8861
Mailing Address - Country:US
Mailing Address - Phone:928-514-3722
Mailing Address - Fax:
Practice Address - Street 1:8700 S HIGHWAY 95
Practice Address - Street 2:
Practice Address - City:MOHAVE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86440-8519
Practice Address - Country:US
Practice Address - Phone:928-768-7113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ294574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily