Provider Demographics
NPI:1245035070
Name:BLUVAS-BODFIELD, CHAUNDRA M
Entity type:Individual
Prefix:
First Name:CHAUNDRA
Middle Name:M
Last Name:BLUVAS-BODFIELD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7502 PARK VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2540
Mailing Address - Country:US
Mailing Address - Phone:402-657-4135
Mailing Address - Fax:
Practice Address - Street 1:7502 PARK VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-2540
Practice Address - Country:US
Practice Address - Phone:402-657-4135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care