Individual
CHANTELL DESHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2 PENN BLVD STE 103, PHILADELPHIA, PA 19144-1402
(215) 842-0406
Mailing address
442 E PHIL ELLENA ST, PHILADELPHIA, PA 19119-1943
(267) 974-3971
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
SP020342
PA
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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