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General NPI Number Information
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NPI Number | 1487905014
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Entity Type | Individual
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Provider Name | MALDALENA PATRICE CHAVIS CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2012
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 161 CECIL B MOORE AVE APT 204
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City | PHILADELPHIA
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State | PA
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Zip | 19122-3243
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Country | US
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Telephone | 866-306-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 3637 OLD YORK RD
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City | PHILADELPHIA
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State | PA
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Zip | 19140-4229
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Country | US
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Telephone | 215-787-7441
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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 | SP012415
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN.29822.APRN
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN11039599
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024193620
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 14266
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ15356500
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License Number State | NJ
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