Provider Demographics
NPI:1912146325
Name:SCANES, CHARMAIGNE (FNP)
Entity type:Individual
Prefix:
First Name:CHARMAIGNE
Middle Name:
Last Name:SCANES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:CHARMAIGNE
Other - Middle Name:
Other - Last Name:SCANES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSN,MSN,APRNRNP FNP
Mailing Address - Street 1:22644 W PIMA ST
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-8945
Mailing Address - Country:US
Mailing Address - Phone:845-337-9665
Mailing Address - Fax:833-527-1531
Practice Address - Street 1:12725 W INDIAN SCHOOL RD STE E
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-9520
Practice Address - Country:US
Practice Address - Phone:845-337-9665
Practice Address - Fax:833-527-1531
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF346893363LF0000X
AZ243834363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAPRN-RNP243834OtherAZBN