Provider Demographics
NPI:1508311523
Name:SMITH, CHALANDER
Entity Type:Individual
Prefix:
First Name:CHALANDER
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 REDBUD ST
Mailing Address - Street 2:
Mailing Address - City:LA PLACE
Mailing Address - State:LA
Mailing Address - Zip Code:70068-4721
Mailing Address - Country:US
Mailing Address - Phone:504-296-1227
Mailing Address - Fax:
Practice Address - Street 1:223 REDBUD ST
Practice Address - Street 2:
Practice Address - City:LA PLACE
Practice Address - State:LA
Practice Address - Zip Code:70068-4721
Practice Address - Country:US
Practice Address - Phone:504-296-1227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2024-02-20
Deactivation Date:2023-03-07
Deactivation Code:
Reactivation Date:2024-02-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health