Individual
CODY CHATHAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-8531
Mailing address
PO BOX 94645, SEATTLE, WA 98124-6945
(509) 474-3131
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R31674
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18827
—
ND
Enumeration date
03/20/2014
Last updated
09/21/2015
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