Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1104587369 |
---|---|
Provider Name | Kellie Chieu |
First Address | Chapel Hill, NC 27599 |
Second Address | Chapel Hill, NC 27599 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2022 |
Last Update Date | 09/01/2022 |