Provider Demographics
NPI:1386181279
Name:CHENAULT, JASON C (ACPI, CEM, OHCC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:C
Last Name:CHENAULT
Suffix:
Gender:M
Credentials:ACPI, CEM, OHCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 STATE ST
Mailing Address - Street 2:SUITE 202B
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1419
Mailing Address - Country:US
Mailing Address - Phone:814-490-6584
Mailing Address - Fax:
Practice Address - Street 1:900 STATE ST
Practice Address - Street 2:SUITE 202B
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1419
Practice Address - Country:US
Practice Address - Phone:814-490-6584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator