Individual
CHANTEL WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2950 SW BOXWOOD CIR, PORT ST LUCIE, FL 34953-6967
(772) 985-1261
Mailing address
2950 SW BOXWOOD CIR, PORT ST LUCIE, FL 34953-6967
(772) 985-1261
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
721672
—
FL
Enumeration date
07/25/2018
Last updated
07/25/2018
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