Provider Demographics
NPI:1760990683
Name:CHARLES, DENISE (CNA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:CHARLES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5098 ASHLEY LAKE DR
Mailing Address - Street 2:1022
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3183
Mailing Address - Country:US
Mailing Address - Phone:954-864-7123
Mailing Address - Fax:
Practice Address - Street 1:5098 ASHLEY LAKE DR
Practice Address - Street 2:1022
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3183
Practice Address - Country:US
Practice Address - Phone:954-864-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide