Provider Demographics
NPI:1437795580
Name:MERCADEL, CHANEL
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:
Last Name:MERCADEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHANEL
Other - Middle Name:
Other - Last Name:MERCADEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6631 W LAVERNE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2504
Mailing Address - Country:US
Mailing Address - Phone:504-234-5912
Mailing Address - Fax:
Practice Address - Street 1:6631 W LAVERNE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2504
Practice Address - Country:US
Practice Address - Phone:504-234-5912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator