Basic Information
| Provider Information | |||||||||
| NPI: | 1144611054 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRAN | ||||||||
| FirstName: | CHRIS | ||||||||
| MiddleName: | T. | ||||||||
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| Credential: | ACNP, CRNFA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1875 W FRYE RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852246184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809175600 | ||||||||
| FaxNumber: | 6022944499 | ||||||||
| Practice Location | |||||||||
| Address1: | 1875 W FRYE RD STE 300 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809175600 | ||||||||
| FaxNumber: | 6022944499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2015 | ||||||||
| LastUpdateDate: | 10/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | AP7613 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.