Provider Demographics
NPI:1164028536
Name:ROWBERRY, CHALEA ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHALEA
Middle Name:ANN
Last Name:ROWBERRY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 E 2200 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1753
Mailing Address - Country:US
Mailing Address - Phone:801-318-3491
Mailing Address - Fax:
Practice Address - Street 1:1248 E 90 N STE 300
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2956
Practice Address - Country:US
Practice Address - Phone:801-756-9635
Practice Address - Fax:801-216-8357
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8164237-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily