MEDICARE: VIRGINIE CHAVANNES

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	363LP2300X	Primary Care Nurse Practitioner	26NJ01205400	NJ

General Provider Information

NPI Number	:	1962168401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIE CHAVANNES

Provider Business Mailing Address
First Line	:	76 MANSFIELD VLG
Second Line	:
City	:	HACKETTSTOWN
State	:	NJ
Zip	:	07840-3615
Country	:	US
Telephone Number	:	561-229-6153
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 MANSFIELD VLG
Second Line	:
City	:	HACKETTSTOWN
State	:	NJ
Zip	:	07840-3615
Country	:	US
Telephone Number	:	561-229-6153
Fax Number	:

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

Provider Enumeration Date	:	11/09/2021
Last Update Date	:	07/01/2026

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Directions to “ VIRGINIE CHAVANNES ” Practice Location

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