Provider Demographics
NPI:1831784073
Name:CHAVEZ, TINA MELINDA (APRN)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MELINDA
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3838 N CAMPBELL AVE
Mailing Address - Street 2:BLDG 2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1454
Mailing Address - Country:US
Mailing Address - Phone:520-874-2778
Mailing Address - Fax:520-694-3330
Practice Address - Street 1:2800 E AJO WAY STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-6204
Practice Address - Country:US
Practice Address - Phone:520-874-2720
Practice Address - Fax:520-694-3330
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ255283363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner