Provider Demographics
NPI:1982220364
Name:READ, CHANTELLE NICOLE (RN)
Entity Type:Individual
Prefix:
First Name:CHANTELLE
Middle Name:NICOLE
Last Name:READ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 ROBIN DR
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76262-9301
Mailing Address - Country:US
Mailing Address - Phone:817-692-6200
Mailing Address - Fax:
Practice Address - Street 1:1216 ROBIN DR
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76262-9301
Practice Address - Country:US
Practice Address - Phone:817-692-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX949181163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse