Provider Demographics
NPI:1881566115
Name:CHICHIA, ANNETTE DANAY (FNP)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:DANAY
Last Name:CHICHIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 W 1600 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-2301
Mailing Address - Country:US
Mailing Address - Phone:801-471-3611
Mailing Address - Fax:
Practice Address - Street 1:1345 W 1600 N
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-2301
Practice Address - Country:US
Practice Address - Phone:801-471-3611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12505960-4405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine