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NPI Code Detail

MEDICARE: CHANTAY CHERIE BRANCH

MEDICARE:   CHANTAY CHERIE BRANCH
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1801516083
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANTAY CHERIE BRANCH
Provider Business Mailing Address
First Line : 14021 GRAND AVE
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-5701
Country : US
Telephone Number : 651-420-5372
Fax Number :
Provider Business Practice Location Address
First Line : 14021 GRAND AVE
Second Line :
City : BURNSVILLE
State : MN
Zip : 55337-5701
Country : US
Telephone Number : 651-420-5372
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2022
Last Update Date : 03/05/2026

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Directions to “ CHANTAY CHERIE BRANCH ” Practice Location

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