Provider Demographics
NPI:1477177079
Name:CAUSEY, CHANELLE ANSHELA (RN)
Entity Type:Individual
Prefix:
First Name:CHANELLE
Middle Name:ANSHELA
Last Name:CAUSEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 N 57TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2216
Mailing Address - Country:US
Mailing Address - Phone:414-640-5385
Mailing Address - Fax:
Practice Address - Street 1:3840 N 57TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2216
Practice Address - Country:US
Practice Address - Phone:414-640-5385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-31
Last Update Date:2020-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI229440163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health