Provider Demographics
NPI:1790324952
Name:CHEITLIN, ABIGAIL (MSN, RN, CRNP-WHNP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:CHEITLIN
Suffix:
Gender:F
Credentials:MSN, RN, CRNP-WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 BUSH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5420
Mailing Address - Country:US
Mailing Address - Phone:510-295-7926
Mailing Address - Fax:
Practice Address - Street 1:1357 OAKLAND CT
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4337
Practice Address - Country:US
Practice Address - Phone:925-935-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95013578363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health