Provider Demographics
NPI:1275193344
Name:PERRY, CHANTEL GIOVANNI (MSN, NP, AGNP-C)
Entity Type:Individual
Prefix:MS
First Name:CHANTEL
Middle Name:GIOVANNI
Last Name:PERRY
Suffix:
Gender:F
Credentials:MSN, NP, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8877 FRANKWAY DR APT 5532
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1912
Mailing Address - Country:US
Mailing Address - Phone:832-282-3394
Mailing Address - Fax:
Practice Address - Street 1:8877 FRANKWAY DR APT 5532
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1912
Practice Address - Country:US
Practice Address - Phone:832-282-3394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX802535163WM0705X
TXAG02190088363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care