MEDICARE: MRS. LILLIAN F CHINAULT NP, MHA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	800156	NC

General Provider Information

NPI Number	:	1851364053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LILLIAN F CHINAULT NP, MHA

Provider Business Mailing Address
First Line	:	104 N TAMILYNN CIR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-3816
Country	:	US
Telephone Number	:	919-462-3222
Fax Number	:

Provider Business Practice Location Address
First Line	:	2301 REXWOODS DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-3366
Country	:	US
Telephone Number	:	919-782-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	07/08/2007

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