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NPI Code Detail

MEDICARE: CHANTAL RENEE WHITE

MEDICARE: CHANTAL RENEE WHITE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1124788732
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTAL RENEE WHITE
Provider Business Mailing Address
First Line : 5038 STEWART PARK APT SUITE
Second Line :
City : NORWOOD
State : OH
Zip : 45212-2212
Country : US
Telephone Number : 513-780-2737
Fax Number :
Provider Business Practice Location Address
First Line : 2600 VICTORY PKWY
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1711
Country : US
Telephone Number : 513-751-7747
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2021
Last Update Date : 03/03/2022

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Directions to “ CHANTAL RENEE WHITE ” Practice Location

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