Provider Demographics
NPI:1033161591
Name:EVERETT, CHAUNA BROOKS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHAUNA
Middle Name:BROOKS
Last Name:EVERETT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:BUTNER
Mailing Address - State:NC
Mailing Address - Zip Code:27509-4600
Mailing Address - Country:US
Mailing Address - Phone:919-575-3900
Mailing Address - Fax:
Practice Address - Street 1:OLD N CAROLINA HWY 75
Practice Address - Street 2:FEDERAL MEDICAL CENTER BUTNER
Practice Address - City:BUTNER
Practice Address - State:NC
Practice Address - Zip Code:27509-4600
Practice Address - Country:US
Practice Address - Phone:919-575-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009625-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5320L1Medicare ID - Type Unspecified
NYQ18126Medicare UPIN