Individual
DOMINIQUE CHIANTE BEVERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
804 MARTIN ST, GREENWOOD, MS 38930-3318
(662) 385-0987
Mailing address
804 MARTIN ST, GREENWOOD, MS 38930-3318
(662) 385-0987
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
MS
376K00000X
Nurse's Aide
Primary
75626
MS
Other
Enumeration date
04/13/2021
Last updated
08/18/2022
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