Provider Demographics
NPI:1801657184
Name:CORDES, PAULETTE MCBRIDE (CHES)
Entity type:Individual
Prefix:MRS
First Name:PAULETTE
Middle Name:MCBRIDE
Last Name:CORDES
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3505 CHIMNEY HILL CT APT 102
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7046
Mailing Address - Country:US
Mailing Address - Phone:757-748-7641
Mailing Address - Fax:
Practice Address - Street 1:3505 CHIMNEY HILL CT APT 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7046
Practice Address - Country:US
Practice Address - Phone:757-748-7641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA21961174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty