MEDICARE: MS. CHANELL MCDONALD PMHNP-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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11043610	FL

General Provider Information

NPI Number	:	1831638931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHANELL MCDONALD PMHNP-BC

Provider Business Mailing Address
First Line	:	550 SE 6TH AVE STE 200-B2
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5306
Country	:	US
Telephone Number	:	561-489-8266
Fax Number	:	561-710-7643

Provider Business Practice Location Address
First Line	:	550 SE 6TH AVE STE 200-B2
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5306
Country	:	US
Telephone Number	:	561-223-9651
Fax Number	:

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

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	04/14/2026

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