Provider Demographics
NPI:1962861468
Name:PERRYMAN, CHANTE
Entity Type:Individual
Prefix:
First Name:CHANTE
Middle Name:
Last Name:PERRYMAN
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 1:2041 CREATIVE DR STE 100
Mailing Address - Street 2:#55391
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4264
Mailing Address - Country:US
Mailing Address - Phone:859-396-4969
Mailing Address - Fax:
Practice Address - Street 1:2041 CREATIVE DR STE 100
Practice Address - Street 2:#55391
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4264
Practice Address - Country:US
Practice Address - Phone:859-396-4969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula