Individual
JUDITH LEACH CHAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
STUDENT HEALTH CTR, CLARKSON UNIVERSITY, POTSDAM, NY 13699-0001
(315) 268-6633
Mailing address
17 WOODLAND DR, MASSENA, NY 13662-3451
(315) 384-3044
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300006-1
NY
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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