Individual
CHARLES E CHATFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
311 LITTLE BRICK ST, CAMERON, MO 64429-1230
(816) 922-2651
Mailing address
5301 FARAON ST STE 120, SAINT JOSEPH, MO 64506-3512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
136963
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
161395
BLUE CROSS BLUE SHIELD
KS
05
—
200605010A
—
KS
01
—
35170019
BLUE CROSS BLUE SHIELD
MO
05
—
428438907
—
MO
01
—
P00334971
RR MEDICARE
MO
Enumeration date
03/09/2006
Last updated
10/09/2024
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