Provider Demographics
NPI:1902190218
Name:CHAFFEE, PAUL
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:CHAFFEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 POINT DR
Mailing Address - Street 2:UNITED STATES
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89060-2611
Mailing Address - Country:US
Mailing Address - Phone:775-513-8966
Mailing Address - Fax:
Practice Address - Street 1:3900 POINT DR
Practice Address - Street 2:UNITED STATES
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89060-2611
Practice Address - Country:US
Practice Address - Phone:775-513-8966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker