1700333234 NPI number — MRS. GLORIAN CHEHADE BSN, MPH

Table of content: MRS. GLORIAN CHEHADE BSN, MPH (NPI 1700333234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700333234 NPI number — MRS. GLORIAN CHEHADE BSN, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHEHADE
Provider First Name:
GLORIAN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BSN, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORALES APONTE
Provider Other First Name:
GLORIAN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
BSN, MPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700333234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
107 MEEKS CT.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT POLK
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71459-3114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-534-6598
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1585 3RD ST
Provider Second Line Business Practice Location Address:
BAYNE JONES ARMY COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
FORT POLK
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-531-4424
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  FL9211220 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163W00000X , with the licence number: 027074 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)