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NPI Code Detail

MEDICARE: RAICHETON CHEVETTE LE NNP-BC

MEDICARE: RAICHETON CHEVETTE LE NNP-BC
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
1363LN0000XNeonatal Nurse Practitioner11004045FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144879826
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAICHETON CHEVETTE LE NNP-BC
Provider Business Mailing Address
First Line : 7965 CHILTERN DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-2025
Country : US
Telephone Number : 317-626-1031
Fax Number :
Provider Business Practice Location Address
First Line : 1005 JOE DIMAGGIO DR
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-5402
Country : US
Telephone Number : 317-626-1031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2019
Last Update Date : 02/04/2026

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