Provider Demographics
NPI:1841610045
Name:CHIN, CLAUDETTE ROSE (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:CLAUDETTE
Middle Name:ROSE
Last Name:CHIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4146 NW 48TH AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4717
Mailing Address - Country:US
Mailing Address - Phone:954-535-0824
Mailing Address - Fax:954-535-0824
Practice Address - Street 1:4146 NW 48TH AVE
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-4717
Practice Address - Country:US
Practice Address - Phone:954-535-0824
Practice Address - Fax:954-535-0824
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-27
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3095842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily