Individual
DALE CHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3000 ESSEX RD, TINTON FALLS, NJ 07753-2631
(732) 643-2070
(732) 643-2015
Mailing address
701 MAIDEN CHOICE LN, CATONSVILLE, MD 21228-5968
(732) 643-2070
(732) 643-2015
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26N007564700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
522114204B
BCBS OF NJ
—
05
—
7700300
—
NJ
01
—
8304132
EVERCARE
—
Enumeration date
07/02/2006
Last updated
09/04/2009
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