Provider Demographics
NPI:1750071833
Name:CHUA, KRISTI A (RN)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:A
Last Name:CHUA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6815 W CACTUS
Mailing Address - Street 2:NURSE OFFICE
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381
Mailing Address - Country:US
Mailing Address - Phone:623-937-5090
Mailing Address - Fax:
Practice Address - Street 1:6815 W CACTUS
Practice Address - Street 2:NURSE OFFICE
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381
Practice Address - Country:US
Practice Address - Phone:623-937-5090
Practice Address - Fax:623-937-5349
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN119202163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse