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General NPI Number Information
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NPI Number | 1770383937
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Entity Type | Individual
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Provider Name | CHANTEL MONAY SMITH APN
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Gender | Female
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 412 CREEK CROSSING BLVD
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City | HAINESPORT
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State | NJ
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Zip | 08036-2768
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Country | US
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Telephone | 856-764-7660
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Fax |
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Provider Business Mailing Address
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Address Line | 5142 HOLMECREST RD
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City | PENNSAUKEN
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State | NJ
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Zip | 08109-4513
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Country | US
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Telephone | 856-529-7556
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ15258900
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License Number State | NJ
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