Provider Demographics
NPI:1598543100
Name:CHANTRA, STEPHANIE SAKUNA (RN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:SAKUNA
Last Name:CHANTRA
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 1:15319 LEILA BEND DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-3999
Mailing Address - Country:US
Mailing Address - Phone:832-350-9545
Mailing Address - Fax:
Practice Address - Street 1:15319 LEILA BEND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-3999
Practice Address - Country:US
Practice Address - Phone:832-350-9545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX940353163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse