Provider Demographics
NPI:1013481456
Name:PYATT, CHANEL DENISE
Entity Type:Individual
Prefix:
First Name:CHANEL
Middle Name:DENISE
Last Name:PYATT
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 1:3317 BLAINE ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-1328
Mailing Address - Country:US
Mailing Address - Phone:202-710-7979
Mailing Address - Fax:
Practice Address - Street 1:3317 BLAINE ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-1328
Practice Address - Country:US
Practice Address - Phone:202-710-7979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker