Individual
LEA C CHIAVARAS
Active
Individual
LEA C CHIAVARAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NUR-RN-LIC-74637
MT
163W00000X
Registered Nurse
R 169354-2
MN
363LG0600X
Gerontology Nurse Practitioner
Primary
NUR-RN-LIC-74637
MT
363LG0600X
Gerontology Nurse Practitioner
R 169354-2
MN
Other
Enumeration date
12/07/2010
Last updated
10/16/2015
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