Individual
CHENELL DOMENIQUE SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
17 LAKEVIEW RD, POUGHKEEPSIE, NY 12603-4343
(845) 380-5873
Mailing address
17 LAKEVIEW RD, POUGHKEEPSIE, NY 12603-4343
(845) 380-5873
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
698338
NY
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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