Provider Demographics
NPI:1558651869
Name:CARTER, CHEKENA DENEICE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CHEKENA
Middle Name:DENEICE
Last Name:CARTER
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 1:6611 W PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-7000
Mailing Address - Country:US
Mailing Address - Phone:602-325-5580
Mailing Address - Fax:
Practice Address - Street 1:357 CORTE TROVA
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4408
Practice Address - Country:US
Practice Address - Phone:619-500-5674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA794019163WC0200X
AZRN128702163WC0200X
AZAP4413363LF0000X
CA21505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine