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Individual
SOPHIA RACHEL CHACKO
Active
Individual
SOPHIA RACHEL CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., C.P.R.N
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR17168500
NJ
163W00000X
Registered Nurse
RN650774
PA
363LF0000X
Family Nurse Practitioner
Primary
SP014506
PA
Other
Enumeration date
01/22/2015
Last updated
02/20/2018
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