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General NPI Number Information
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NPI Number | 1477162584
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Entity Type | Individual
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Provider Name | CHANTELL MONIQUE COMANS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2020
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Last Update Date | 07/24/2020
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Provider Practice Location Address
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Address Line | 1401 S UNIVERSITY DR
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City | NACOGDOCHES
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State | TX
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Zip | 75961-6488
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Country | US
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Telephone | 936-560-5413
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Fax |
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Provider Business Mailing Address
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Address Line | 296 SCR 10A
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City | TAYLORSVILLE
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State | MS
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Zip | 39168
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Country | US
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Telephone | 601-422-8165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1004364
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License Number State | TX
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