Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 0024175435 | VA |
NPI | 1003390949 |
---|---|
Provider Name | Cynthia Chenault |
First Address | Midlothian, VA 23114-1252 |
Second Address | Richmond, VA 23298-5051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2018 |
Last Update Date | 17/09/2018 |