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General NPI Number Information
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NPI Number | 1912354630
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Entity Type | Individual
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Provider Name | DENISE CHAMBERY
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Gender | Female
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 5707 W 122ND PL
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City | CROWN POINT
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State | IN
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Zip | 46307-8778
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Country | US
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Telephone | 219-776-3319
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 471
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City | CROWN POINT
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State | IN
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Zip | 46308-0471
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Country | US
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Telephone | 219-776-3319
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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 | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 06004217A
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License Number State | IN
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