Provider Demographics
NPI:1063011518
Name:ANDREWS, CHANELLE D
Entity Type:Individual
Prefix:MRS
First Name:CHANELLE
Middle Name:D
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-2856
Mailing Address - Country:US
Mailing Address - Phone:856-906-6504
Mailing Address - Fax:
Practice Address - Street 1:38 LINCOLN DR
Practice Address - Street 2:
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2856
Practice Address - Country:US
Practice Address - Phone:856-214-2715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-25
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty