Provider Demographics
NPI:1154098010
Name:CAVALLERO, GIA CHRISTINE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:GIA
Middle Name:CHRISTINE
Last Name:CAVALLERO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13995 W STATLER BLVD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-5501
Mailing Address - Country:US
Mailing Address - Phone:623-478-3100
Mailing Address - Fax:623-478-3300
Practice Address - Street 1:13995 W STATLER BLVD BLDG 1
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-5501
Practice Address - Country:US
Practice Address - Phone:623-478-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-26
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN197408163WE0003X
AZ309785363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency