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General NPI Number Information
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NPI Number | 1114591104
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Entity Type | Organization
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Legal Business Name | CHELLE HEALTH LLC
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Dates
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Enumeration Date | 05/14/2021
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 48 S 2500 W STE 240
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City | HURRICANE
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State | UT
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Zip | 84737-3382
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Country | US
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Telephone | 435-979-8627
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Fax |
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Provider Business Mailing Address
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Address Line | 48 S 2500 W STE 240
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City | HURRICANE
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State | UT
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Zip | 84737-3382
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Country | US
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Telephone | 435-979-8627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE WATERS
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Credential | NP-C
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Telephone | 435-979-8627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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