MEDICARE: MRS. SHEREE CHAUPPETTE RN

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
1	376G00000X	Nursing Home Administrator	342700243	CA

General Provider Information

NPI Number	:	1639662653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHEREE CHAUPPETTE RN

Provider Business Mailing Address
First Line	:	6813 MARINVALE DR
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621-1937
Country	:	US
Telephone Number	:	916-761-9565
Fax Number	:

Provider Business Practice Location Address
First Line	:	6813 MARINVALE DR
Second Line	:
City	:	CITRUS HEIGHTS
State	:	CA
Zip	:	95621-1937
Country	:	US
Telephone Number	:	916-761-9565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2018
Last Update Date	:	06/13/2018

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