Active NPI
Charisse Ann Tan, BSN, RN
- Registered Nurse
- Avondale, AZ
National Provider Identifier
1043955313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 248353
- Practice address
- 10875 W Cambridge Ave
Avondale, AZ 85392-5807 - Phone
- (602) 540-6932
- NPI assigned
- May 2, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 248353 | AZ | Primary |
Addresses
Primary practice location
10875 W Cambridge Ave
Avondale, AZ 85392-5807
Mailing address
10875 W Cambridge Ave
Avondale, AZ 85392-5807
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 248353 | AZ | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651449600000",
"number": "1043955313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10875 W CAMBRIDGE AVE",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853925807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10875 W CAMBRIDGE AVE",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853925807",
"telephone_number": "602-540-6932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "CHARISSE",
"middle_name": "ANN",
"credential": "BSN, RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-02",
"last_updated": "2022-05-02",
"certification_date": "2022-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AZ",
"license": "248353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.