Provider Demographics
NPI:1750518395
Name:CHIRCO, NAHLA (FNP)
Entity type:Individual
Prefix:DR
First Name:NAHLA
Middle Name:
Last Name:CHIRCO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 N 51ST AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-1237
Mailing Address - Country:US
Mailing Address - Phone:623-209-5555
Mailing Address - Fax:623-247-1905
Practice Address - Street 1:4700 N 51ST AVE STE 6
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1237
Practice Address - Country:US
Practice Address - Phone:623-209-5555
Practice Address - Fax:623-247-1905
Is Sole Proprietor?:No
Enumeration Date:2009-06-21
Last Update Date:2022-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10142363LP2300X
MI4704242161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily