Provider Demographics
NPI:1023788544
Name:CHIAVENTONE, CARRIGAN LYNNAE
Entity type:Individual
Prefix:
First Name:CARRIGAN
Middle Name:LYNNAE
Last Name:CHIAVENTONE
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 1:527 EASTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3819
Mailing Address - Country:US
Mailing Address - Phone:815-795-7855
Mailing Address - Fax:
Practice Address - Street 1:527 EASTFIELD DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3819
Practice Address - Country:US
Practice Address - Phone:815-795-7855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program