MEDICARE: CASEY CHENAULT

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	3747P1801X	Personal Care Attendant
2	376J00000X	Homemaker
3	172A00000X	Driver

General Provider Information

NPI Number	:	1881410884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY CHENAULT

Provider Business Mailing Address
First Line	:	210 MOUNT LOGAN DR
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-2720
Country	:	US
Telephone Number	:	740-804-5777
Fax Number	:

Provider Business Practice Location Address
First Line	:	210 MOUNT LOGAN DR
Second Line	:
City	:	CHILLICOTHEE
State	:	OH
Zip	:	45601-2720
Country	:	US
Telephone Number	:	740-804-5777
Fax Number	:

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

Provider Enumeration Date	:	11/25/2024
Last Update Date	:	11/25/2024

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Directions to “ CASEY CHENAULT ” Practice Location

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