Provider Demographics
NPI:1477178622
Name:VARNER, CHALETTA (CPT)
Entity Type:Individual
Prefix:
First Name:CHALETTA
Middle Name:
Last Name:VARNER
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 770
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-0770
Mailing Address - Country:US
Mailing Address - Phone:614-367-6578
Mailing Address - Fax:
Practice Address - Street 1:5410 IVYWOOD LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-3909
Practice Address - Country:US
Practice Address - Phone:614-306-2565
Practice Address - Fax:614-417-3189
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-13
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHEX1111251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health