Individual
CHANAE COTTRELL-PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10080 SW INNOVATION WAY, PORT ST LUCIE, FL 34987-2127
(772) 344-3811
(772) 344-3890
Mailing address
10014 WHITE BLUFF RD APT 1503, SAVANNAH, GA 31406-5605
(801) 616-8236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9117794
FL
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
PA9117794
FL
Other
Enumeration date
10/27/2023
Last updated
10/11/2024
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