Provider Demographics
NPI:1821710351
Name:SCOTT, CHUCKIA TENINEY
Entity Type:Individual
Prefix:
First Name:CHUCKIA
Middle Name:TENINEY
Last Name:SCOTT
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 1:1510 CLINE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-7915
Mailing Address - Country:US
Mailing Address - Phone:980-781-6297
Mailing Address - Fax:
Practice Address - Street 1:1510 CLINE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-7915
Practice Address - Country:US
Practice Address - Phone:980-781-6297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health