Individual
COURTNEY ADAIR CHENAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
130 DIVISION ST, DERBY, CT 06418-1326
(203) 732-1330
(203) 732-1332
Mailing address
130 DIVISION ST, DERBY, CT 06418-1326
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4953
CT
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
06/11/2020
Last updated
01/04/2022
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