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Individual

CHARLIE JORDAN CHANEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APN

Contact information

Practice address
500 W 10TH ST, WILMINGTON, DE 19801-1422
(302) 984-3380
(302) 691-0475
Mailing address
500 W 10TH ST, WILMINGTON, DE 19801-1422
(302) 984-3380
(302) 691-0475

Taxonomy

Speciality
Code
Description
License number
State
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
LE-0000160
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000022914
DE
Enumeration date
02/02/2007
Last updated
07/09/2007
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