Provider Demographics
NPI:1982159539
Name:LESSARD-CHAUDOIN, CHANTELLE (MPH, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHANTELLE
Middle Name:
Last Name:LESSARD-CHAUDOIN
Suffix:
Gender:F
Credentials:MPH, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7699 E PINNACLE PEAK RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6322
Mailing Address - Country:US
Mailing Address - Phone:480-300-4663
Mailing Address - Fax:
Practice Address - Street 1:7699 E PINNACLE PEAK RD STE 115
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255
Practice Address - Country:US
Practice Address - Phone:480-300-4663
Practice Address - Fax:480-300-4888
Is Sole Proprietor?:No
Enumeration Date:2016-08-23
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ170211OtherMEDICARE