Provider Demographics
NPI:1619738838
Name:CHAUNCEY, DARLENE LOWERY
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:LOWERY
Last Name:CHAUNCEY
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 1:7125 BERRY RD
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-4003
Mailing Address - Country:US
Mailing Address - Phone:813-713-3264
Mailing Address - Fax:
Practice Address - Street 1:7125 BERRY RD
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-4003
Practice Address - Country:US
Practice Address - Phone:813-713-3264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty