Provider Demographics
NPI:1386955573
Name:HEMENWAY, CHAROLETTE (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHAROLETTE
Middle Name:
Last Name:HEMENWAY
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHAROLETTE
Other - Middle Name:
Other - Last Name:HEMENWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:16211 N SCOTTSDALE RD #232
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254
Mailing Address - Country:US
Mailing Address - Phone:808-517-1225
Mailing Address - Fax:
Practice Address - Street 1:1855 W BASELINE RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-9000
Practice Address - Country:US
Practice Address - Phone:480-831-7566
Practice Address - Fax:480-831-7563
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP7989363LF0000X, 363LF0000X
KY3006445363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ047398Medicaid