Provider Demographics
NPI:1396083093
Name:GREENE, CHANTEL VICTORIA (MA)
Entity type:Individual
Prefix:MS
First Name:CHANTEL
Middle Name:VICTORIA
Last Name:GREENE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 ACCOMMODATION ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-4217
Mailing Address - Country:US
Mailing Address - Phone:804-878-4263
Mailing Address - Fax:
Practice Address - Street 1:2015 ACCOMMODATION ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-4217
Practice Address - Country:US
Practice Address - Phone:804-878-4263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide