MEDICARE: CHASNA AVERY SKINNER

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	347C00000X	Private Vehicle	28373946	NC

General Provider Information

NPI Number	:	1902578875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHASNA AVERY SKINNER

Provider Business Mailing Address
First Line	:	102B ARTHUR STREET
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834
Country	:	US
Telephone Number	:	252-714-4655
Fax Number	:

Provider Business Practice Location Address
First Line	:	102B ARTHUR STREET
Second Line	:
City	:	GREENVILLE
State	:	NC
Zip	:	27834-2783
Country	:	US
Telephone Number	:	252-714-4655
Fax Number	:

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

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	09/22/2022

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Directions to “ CHASNA AVERY SKINNER ” Practice Location

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