Provider Demographics
NPI:1063784387
Name:CHINN, CARI BETH (FNP)
Entity type:Individual
Prefix:MRS
First Name:CARI
Middle Name:BETH
Last Name:CHINN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CARI
Other - Middle Name:BETH
Other - Last Name:DITTUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 275
Mailing Address - Street 2:
Mailing Address - City:CALHAN
Mailing Address - State:CO
Mailing Address - Zip Code:80808-0275
Mailing Address - Country:US
Mailing Address - Phone:719-347-0100
Mailing Address - Fax:719-347-0851
Practice Address - Street 1:560 CRYSTOLA ST
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-8699
Practice Address - Country:US
Practice Address - Phone:719-347-0100
Practice Address - Fax:719-347-0851
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONP990263363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily