Provider Demographics
NPI:1982101960
Name:CHAVIS, WHITNEY (RN)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:CHAVIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4857 CARTERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-3908
Mailing Address - Country:US
Mailing Address - Phone:804-598-2682
Mailing Address - Fax:
Practice Address - Street 1:6200 HOLLY TRACE DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-8803
Practice Address - Country:US
Practice Address - Phone:804-461-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001257790163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine