Provider Demographics
NPI:1275281511
Name:HOWARD, CHANTELL MONICK (ELECTROLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:CHANTELL
Middle Name:MONICK
Last Name:HOWARD
Suffix:
Gender:F
Credentials:ELECTROLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:BONDURANT
Mailing Address - State:IA
Mailing Address - Zip Code:50035-2161
Mailing Address - Country:US
Mailing Address - Phone:515-681-3143
Mailing Address - Fax:
Practice Address - Street 1:100 COURT AVE STE 440
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2216
Practice Address - Country:US
Practice Address - Phone:515-681-3143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-15
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111338174400000X, 374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
No174400000XOther Service ProvidersSpecialist