Provider Demographics
NPI:1003196247
Name:CHATHAM, CARI A (BSN RN)
Entity Type:Individual
Prefix:MRS
First Name:CARI
Middle Name:A
Last Name:CHATHAM
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W1048 MIRAMAR RD
Mailing Address - Street 2:
Mailing Address - City:EAST TROY
Mailing Address - State:WI
Mailing Address - Zip Code:53120-2227
Mailing Address - Country:US
Mailing Address - Phone:414-491-1236
Mailing Address - Fax:
Practice Address - Street 1:W1048 MIRAMAR RD
Practice Address - Street 2:
Practice Address - City:EAST TROY
Practice Address - State:WI
Practice Address - Zip Code:53120-2227
Practice Address - Country:US
Practice Address - Phone:414-491-1236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI133654-030163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics